Nail changes in minimal alopecia areata

ABSTRACT

Nail involvement in alopecia areata is relatively common. The reported incidence ranged from 10 to 66%, and in another it was as low as 3.65%. Onychodystrophy generally is most common and severe in patients with extensive alopecia, but it has been reported with minimal hair loss. This work aimed at evaluating the types and the prevalence of nail changes occurring in the patchy type of alopecia areata with minimal hair loss. Eighty four patients with patchy type of alopecia areata of minimal hair loss were included in this study. Full clinical examination and pertinent laboratory investigations were done for them. 44.1% of patients presented with nail changes; 36.84% had maturity onset and 59.25% had juvenile onset alopecia areata. 48.27% gave history of recurrence of alopecia areata. Fine pitting occurred in 32.43%, fine pitting with longitudinal ridging in 24.32%, longitudinal ridging alone in 8.11%, punctuate Leukonychia in 16.22%, Beau's lines in 10.81%, onycholysis and nail shedding in 5.41%, and reddening of the nail in 2.70% of patients. Nail changes are common in alopecia areata, occurring even in mild cases with minimal hair loss, being more with longer duration and recurrence. Children and adolescents are more prone to nail changes than adults. Diffuse fine pitting and longitudinal ridging are the commonest nail affection