Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.

Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:

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Dear Martin,

I've been having problems with my fingernails and toenails for a good six months now. They become brittle, crumble. All nails show vertical grooves. Sometimes part of the nail loosens. The result is that I get stuck everywhere when I want to do something. I don't feel any pain but it is quite difficult. Sometimes the nail is very thin or parts are completely gone.

I am 62 years old and have never experienced such problems. At first, fungus (Fungus) was thought of. But after a visit to a clinic it turned out to be 20 nail distrophy. I had never heard of this. The cause is unknown, the doctor said.

Now it appears that there is no medication or no adequate treatment for it. Is this correct? I've been taking vitamins every day for 1 month now, but I don't see any improvement yet.

What do you advise me to do? Apart from the problems described above, it is also not a pretty sight.
I can of course mask my nails, but that only makes working more difficult.

I seem to remember that Michael Jackson did too. The reason behind that is unknown to me.
I'm white already, unfortunately I can't sing and dance at all....;-))

Regards,

W.

******

Dear W,
Could you send some pictures of your nails? Do you use medicines? Are you otherwise healthy. Anything worth noting in your history? Do you smoke? Alcohol? 
Twenty nail distrophy is a genetic disorder that mainly occurs in children. Your symptoms do fit. There is no known treatment other than proper care.
Currently, the antimicotic griseofulvin is being experimented with corticosteroid injections into the nail bed with varying degrees of success. This works especially if the underlying cause is lichen planus. There have also been successes with topical tacrolimus treatment.
Not all 20 nails need to be affected. Some pictures of nail lichen planus have been added. Lichen Planus can be diagnosed with a biopsy. At first glance, many nail diseases look almost 100% alike.
Yours faithfully,
Martin Vasbinder

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