Nail changes in alopecia areata: an update and review

Chelidze, Khatiya; Lipner, Shari R.

doi:10.1111/ijd.13866

Cited by 62 publications

(85 citation statements)

References 46 publications

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“…Our study supports these findings, with a longer disease course ( P = 0.005) and a lower mean age of onset in severe forms ( P = 0.001). Coexisting nail changes noted in AA patients are also considered as poor prognosis indicators . In fact, patients with nail problems exhibit more severe forms of AA .…”

Section: Discussionmentioning

confidence: 99%

“…Coexisting nail changes noted in AA patients are also considered as poor prognosis indicators. 12,29,30 In fact, patients with nail problems exhibit more severe forms of AA. 29 In our study and according to these findings, nail changes were positively correlated with severe AA (P < 0.001) and were mainly represented by trachyonychia (P = 0.01) and nail pitting (P < 0.01).…”

Section: Discussionmentioning

confidence: 99%

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Alopecia areata in Tunisia: epidemio‐clinical aspects and comorbid conditions. A prospective study of 204 cases

et al. 2019

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Background Alopecia areata (AA) is an autoimmune condition that usually presents as patchy, nonscarring hair loss. Autoimmune disorders and atopy are reported as comorbid conditions. We aimed to investigate the demographics, clinical characteristics, and associations of AA in Tunisian patients. Methods Demographic data, pattern of alopecia, age of onset, and associations were evaluated in 204 patients from January 2012 to June 2016. Results Two hundred and four cases of AA were seen. The male to female ratio was 0.68. The mean age at presentation was 23 years old. Positive family history was noticed in 22.1% of patients. Personal history of atopy was associated with AA in 18.1%. Associated autoimmune diseases were thyroid disorders (12.7%), vitiligo (1.5%), psoriasis (three cases), type 1 diabetes (two cases), autoimmune polyendocrinopathy‐candidiasis‐ectodermal dystrophy (APECED) syndrome (two cases), lichen sclerosus atrophicus (one case), and pemphigus vulgaris (one case). Patchy AA was the most common manifestation (49.5%) followed by alopecia universalis (27.5%), alopecia ophiasis (12.7%), and alopecia totalis (10.3%). Nail changes consisting of pitting, trachyonychia, and longitudinal ridging were reported in 24.8%. AA patterns were more severe in females (P = 0.049). Severe forms showed more persistent disease duration (P = 0.005), earlier onset (P = 0.001), and more recurring episodes (P = 0.002) and were significantly associated with nail involvement (P < 0.001). Conclusions Our study aimed to review epidemio‐clinical characteristics and comorbid conditions of AA in Tunisian patients. More severe cases with a pejorative value of early‐onset AA, long disease duration, and nail involvement were seen in our study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Alopecia areata in Tunisia: epidemio‐clinical aspects and comorbid conditions. A prospective study of 204 cases

et al. 2019

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“…Even if it can occur at any age, trachyonychia is a typically paediatric disease, with an average age of onset being 3-12 years old. 4 This condition can be both idiopathic and associated with other dermatologic diseases, as alopecia areata, 5 psoriasis and lichen planus. 6 Nevertheless, multiple reports of a hereditary form of trachyonychia exist in the literature suggesting that there may be some underlying genetic predisposition.…”

Section: Introductionmentioning

confidence: 99%

Trachyonychia: a retrospective study of 122 patients in a period of 30 years

Starace

Alessandrini

Bruni

et al. 2020

Acad Dermatol Venereol

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Background Trachyonychia is a nail disease characterized by longitudinal striations, ridges, fissures and/or pitting. This condition can be both idiopathic and associated with other dermatologic diseases. Objective and methods The aim of this retrospective study was to analyse the clinical features, onychoscopy, therapy efficacy and outcome of 122 patients with trachyonychia visited at the Hair Disease Outpatient Consultations of the Dermatology Unit of the Department of Experimental, Diagnostic and Specialty Medicine of the University of Bologna, from 1988 to 2018. Results Opaque trachyonychia was the most observed type while shiny trachyonychia, less common, was present especially in milder cases. Pitting was the most frequently observed feature (80.3%), followed by koilonychia (45%) and hyperkeratosis (19.6%). Nail matrix longitudinal biopsy was performed for diagnosis confirmation in 29 cases, and spongiotic was the most common pattern. Topical therapy was prescribed in 109 patients while systemic treatments were reserved for severe cases (38 patients); 22 patients did not receive any treatment. A marked improvement in the appearance of the nails or even a total resolution was seen in 63 patients. Conclusions Trachyonychia can occur at any age but is more frequent in children and often associated with alopecia areata. The pathological diagnosis of trachyonychia is not mandatory as the disease has generally a benign outcome. Considering the absence of pain and the high rate of spontaneous resolution, treatment is often prescribed only for cosmetic reasons or reserved for severe cases.

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“…In addition to the more common clinical features mentioned by Strazzulla et al, 1 other nail changes include Beau lines, onycholysis, punctate leukonychia, mottled lunulae, onychomadesis, distal notching, lamellar splitting, ragged cuticles, onychorrhexis, and yellow-brown discoloration. 3 Nail pits, which are shallow with a grid-like distribution, are the most common finding in both children and adults (Fig 1). Although the nail changes are typically asymptomatic, severe onychodystrophy with nail plate crumbling (Fig 2) may be painful and have a negative effect on quality of life.…”

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confidence: 99%

“…We would like to highlight that nail changes are present in up to 66% of patients in whom alopecia areata has been diagnosed, with an average prevalence of 30%. 3 Furthermore, the prevalence of nail changes in these patients is likely underestimated due to lack of symptoms in some cases and subtle onychodystrophy that may be overlooked on physical examination. Dermoscopy, particularly contact dermoscopy using ultrasound gel, is helpful in revealing subtle changes.…”

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confidence: 99%