Nail Abnormalities in Alopecia Areata

Background: Nail abnormalities may be associated with alopecia areata and nail abnormalities in alopecia areata are reported to range from 10%-66%. Objectives : This study investigates the clinical characteristics of nail abnormalities in alopecia areata, such as prevalence depending on sex, age and severities of hair loss. Methods : Prospective analysis was undertaken by examining the finger nails of 424 alopecia areata patients and the nails of 465 non-alopecic patients were examined as controls. Results: The number of the patients was 424 (214 males, 210 females) and their mean age was 28.6 years (range 1-69). Nail abnormalities were noted in 98 (23.1 %) out of 424 patients and in 24 (5.1 %) out of 465 controls. According to age group, the prevalence of nail abnormalities was high at age under 9 (31.7%) and at age of 10-19 (31.6%). The incidence according to severity of hair loss was 20.8% in below 50% of hair loss on scalp, 27.8% in 51 %-100% of hair loss on scalp and 41.5% in 51%-100% of hair loss on the scalp and also involving body hair. The Frequent nail abnormalities were leukonychia punctata (8.5%) and pitting nail (8.0%). The other minor nail abnormalities were onychorrhexis, transverse ridging, trachyonychia, melanonychia, abnormality of lunula, onycholysis and koilonychia. Conclusions : The incidence of nail abnormalities in alopecia areata was significantly higher than in controls and the nail abnormalities were more common in children. The more severe was the degree of alopecia, the higher was the prevalence of nail abnormalities. Leukonychia punctata and pitting nail were frequently found in alopeica areata in Korea. The examination of nail in alopecia areata patients may be helpful in expectation of prognosis. (Korean J Dermatol 2003;41(2) : 152-157)