Nail changes, a common feature of alopecia areata (AA), are a significant source of cosmetic disfigurement and functional impairment. A recent review provides an update of the prevalence, clinical and histopathological features, pathogenesis, differential diagnosis, clinical course, prognosis, and management of nail changes in patients with AA. Literature searches for peer‐reviewed journal articles were conducted using the search terms “nail changes alopecia areata,” “alopecia areata nails,” and with specific searches on “trachyonychia alopecia areata” and “pitting alopecia areata.” Investigators found:
- Nail changes are a common feature of AA, with an average prevalence of 30%, and can cause significant disfigurement and loss of function.
- Pitting and trachyonychia were by far the most common manifestations of AA, with an average prevalence of 20% and 8%, respectively.
- Red spotted lunulae, onycholysis, and punctate leukonychia were other reported findings.
- Other etiologies, such as onychomycosis or lichen planus, may co-exist with or confound the diagnosis.
Chelidze K, Lipner SR. Nail changes in alopecia areata: An update and review. Int J Dermatol. 2018;57(7):776-783. doi:10.1111/ijd.13866.