Twenty-nail dystrophy treated with topical PUVA.

A case of twenty-nail dystrophy treated with topical PUVA is described. The patient, a 19-year-old woman, had a 4-year history of a nail dystrophy involving all finger- and toe-nails. The finger-nail changes were treated with topical PUVA, dose 0.7-1.4 J/cm2 x 3/week. After 7 months excellent improvement was seen, while the untreated toe-nails were unaffected. A maintenance dose of 0.7 J/cm2 x 3/week was necessary to prevent recurrence. We suggest that topical PUVA is worth trying for the treatment of twenty-nail dystrophy.