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Nail Changes in Alopecia Areata and Their Correlation with Disease Severity

Iraqi Postgraduate Medical Journal, 2021, Volume 20, Issue 2, Pages 128-135
10.52573/ipmj.2020.168620

Abstract

Alopecia areata (AA) is a chronic, autoimmune, inflammatory, non-scarring type of hair loss. Significant variations in the presentation of AA have been observed, ranging from small, well-circumscribed patches of hair loss to complete absence of body and scalp hair. Nail involvement is                  a common finding in patients with alopecia areata.
OBJECTIVE:
Study of nail changes in alopecia areata and evaluation of the correlation between the nail changes and severity of alopecia areata
PATIENTS AND METHODS:
The study is an observational, cross-sectional, descriptive study that was carried out at                                         the Dermatology center, Medical City, Teaching Hospital, during the period from May 2018 to July 2019.  The severity of (AA) was measured by the Severity of the Alopecia Tool Score1 (SALT1) score, in 70 patients with different severities of AA. A new measurement tool (Nail in Alopecia Areata Severity Index, NAASI score) was applied for the evaluation of the nail changes associated with AA.
RESULTS: 
Seventy AA patients were divided into two groups, patients with nail changes, group A, which included 48 patients; 33 were males and 15 were females, the mean age was 19.19 ± 14.28 years. Group B included patients without nail changes; 22 patients; 11 were males and 11 were females,                   the mean age was 22.36 ± 11.50 years. NAASI score for patients in group A was 34 ± 31. Pitting  was the most common nail changes (38 patients), followed by trachyonychia, 15 patients. Group A was subdivided into two groups according to severity of AA. The mean NAASI score for the group with mild to moderate AA was 20 ± 23, while it was 56 ± 28 for patients with severe AA. There was positive correlation between SALT1 and NAASI scores.
CONCLUSION:
The prevalence of nail changes in AA was 68.6%. They were associated with early onset and long duration of AA. Pitting was the most common changes. A new scoring system for nail changes was described. Nail changes correlated with severity of AA.
 
Keywords:

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