ABSTRACT
The nail plate surface is rough, sandpapered, and opaque due to inflammation of the proximal nail matrix. When the inflammation is mild and intermittent, the result is the shiny variant. Trachyonychia is not specific to nail lichen planus but may also occur in alopecia areata, psoriasis, eczema, and as an idiopathic condition. Pathology is needed for differential diagnosis but, since it is a benign condition, a biopsy is usually not recommended due to its invasiveness and irrelevance to the course of the disease ( Figure 14.1 ).
