Dermoscopic Assessment of Nail Alterations in Egyptian Patients with Alopecia Areata

Sara Galal; Radwa  Tiranly; Doaa  Pessar; Hala  Elsadek

doi:10.5826/dpc.1601a6035

Dermoscopic Assessment of Nail Alterations in Egyptian Patients with Alopecia Areata

Authors

Sara Galal Dermatology and Venereology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt https://orcid.org/0000-0002-2776-628X
Radwa Tiranly Dermatology and Venereology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Doaa Pessar Dermatology and Venereology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Hala Elsadek Dermatology and Venereology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Keywords:

alopecia areata , dermoscopy, nail changes

Abstract

Introduction: Alopecia areata (AA) is an autoimmune disorder characterized by non-scarring hair loss. Hair and nails have many commonalities related to their development and structure and both can be involved in a range of disorders. Dermoscopy is a valuable noninvasive diagnostic tool that enhances clinical evaluation and treatment monitoring by detecting subtle nail changes not visible to the naked eye.

Aim: The goals of this study were to assess the prevalence and types of various fingernail changes in patients with alopecia areata using dermoscopy and to compare the findings with those observed in healthy controls.

Methods: A case-control study was conducted including 120 patients diagnosed with alopecia areata and 120 healthy individuals as controls. Dermoscopic examination of the fingernails was done for all participants. The severity of alopecia areata was evaluated using the Severity of Alopecia Tool (SALT) score.

Results: Nail changes were observed in 78.3% of patients with alopecia areata, compared to only 14.2% in the control group, showing a statistically significant difference (P<0.05). The most frequent dermoscopic nail change was nail pitting (59%), followed by dry scales on the lateral nail fold (28.3%), scaly cuticle (18.3%), punctate leukonychia (17.5%), onychoschizia (14.2%), and longitudinal ridging (13.3%). There was a significant association between nail changes and disease severity, patient age, and alopecia areata duration.

Conclusions: Nail changes are common in patients with alopecia areata and may serve as valuable prognostic indicators for disease severity.

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