A rare idiopathic disorder of the finger- and toenails characterised by longitudinal ridging, fragility, notching and opalescent discolouration. The nails may become muddy or grubby looking, and the adjacent skin become spongiotic and hyperkeratotic Associations Lichen planus, eczema, psoriasis. alopecia areata Management Generally a failure; PUVA, antifungals and steroids have been tried with little success