Twenty nail dystrophy is a benign disorder of healthy children and is characterized by ridging, pitting, and a rough, lackluster appearance of most or all fingers and toenails. Although these nail changes tend to persist, in some children the nails improve with age over a period of several years. There is no treatment for this condition.
It is not caused by fungus and is not contagious. Occasionally, twenty nail dystrophy can be associated with alopecia areata (a condition causing circular areas of hair loss on the scalp) or lichen planus (multiple small, pink-purple, flat-topped bumps on the skin). Most children have the nail changes only.