Work-induced dermatopathology: unraveling median canaliform dystrophy of Heller in carpet weaving

A 60-year-old woman, a rural carpet weaver with no speci c medical history, presented with a 10-year history of thumb nail dystrophy. This rare condition, known as Heller’s canaliform dystrophy (HCD), is characterized by a central longitudinal depression with parallel transverse ridges resembling a r branch. In this case, it was symmetrically present on both thumb nails with macro-lunula. Notably, there was no paronychia, subungual hyperkeratosis, or pain. Similar ndings were observed on the right big toe nail. HCD is often underdiagnosed, and its diagnosis is clinical. Unlike most cases in the literature where it accompanies psychological issues, here, the dystrophy was linked to the patient's occupation, prompting consideration of it as an occupational pathology. The patient wasn't bothered aesthetically, leading to therapeutic abstention. This case emphasizes the potential association between occupational factors and HCD, urging further discussion and research within the dermatological community.