Elconyxis Induced by Isotretinoin: Myth or Reality?

Abstract

Elconyxia is a rare nail disorder reported in the literature, associated with conditions such as peritonitis, psoriasis, syphilis, reactive arthritis, trauma, or 
retinoid use. Elconyxia due to isotretinoin or oral retinoids is an uncommon, dose-dependent entity that includes onychoschizia, transverse leukonychia, 
onychorrhexis, pyogenic granuloma, onychocryptosis, median canaliform dystrophy (Heller’s dystrophy), and paronychia with onychoschizia being 
the most common clinical manifestation. These signs are not seen with topical retinoids. Nail plate changes typically begin 3 to 4 months after starting the drug, may affect one or all nails, and are potentially reversible once the medication is discontinued. We report a new case in the literature of a male patient with elconyxia secondary to oral retinoids, with full symptom reversal after completing treatment.