Nail Changes in Histiocytosis X

To the Editor.—  Nail changes in histiocytosis X were first described by Bender and Holtzman¹ in 1948. Holzberg et al,² in 1985, reported that nail dystrophy was due to the same atypical cells that cause specific cutaneous lesions. Nail changes can be observed in both fingernails and toenails and consist of longitudinal grooving³; purpuric striae^4,5; hyperkeratosis^2,6; subungual pustules^6,7; thickening, deformation, and pitting of the nail plate¹; onycholysis; and perionyxis.^2,6 Some authors^2,6 have suggested that evolution of onychodystrophy parallels the disease and indicates a poor prognosis; other authors^1,7,8 do not agree.We describe a patient with histiocytosis X and persistent and progressive destruction of the fingernail plates (Fig 1) proved to be due to CD1⁺ histiocytelike cells.

Report of a Case.—  A 31-year-old man was diagnosed wtih diabetes insipidus and progressive hypogonadotropic hypogonadism in 1979. He underwent treatment with vasopressin