Nail involvement in alopecia aereata: A descriptive cross sectional study


  • Rabia Asgher Department of Dermatology, District Headquarter Hospital, Lodhran.
  • Ghania Shahid Department of Dermatology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College Bahawalpur.
  • Naima luqman Department of Dermatology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College Bahawalpur.
  • Amara Amin Department of Dermatology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College Bahawalpur.


Background Alopecia areata (AA) is an autoimmune disorder that affects the pilar follicles and results in hair loss on the scalp and other parts of the body. In some cases, nails may also be affected before or after hair loss, particularly in severe cases. Different nail change patterns exist even after therapy and hair regrowth. This study aimed to identify the pattern of nail changes in alopecia areata patients.   Methods This cross sectional study was conducted at Dermatology Department, BVH, Bahawalpur, from 6th July 2019 to 5th January 2020. A total of 103 patients with alopecia areata, 25-55 years of age and both genders were included. Patients undergoing chemotherapy for any malignancy, pregnant females and known cases of Diabetes Mellitus, Tuberculosis and Chronic renal failure were excluded. After taking informed consent, all patients were evaluated for the severity of alopecia areata (mild/moderate/severe) and different nail changes.   Results Mean ages of patients was 34.81 + 7.09 years in which 81 (78.34%) were between 25 to 40 years of age. Out of 103 patients, 55 (53.40%) were males and 48 (46.60%) were females with male to female ratio of 1.1:1 . The nail changes were found to be pitting in 63 (61.17%), longitudinal ridging in 27 (26.21%) and dystrophy in 13 (12.62%).   Conclusion This study concluded that nail changes observed in alopecia areata patients were pitting, longitudinal ridging and dystrophy.  


Anzengruber F, Maul JT, Kamarachev J, et al.Transient Efficacy of Tofacitinib in Alopecia Areara Universalis. Case Rep Dermatol. 2016;8:102-6.

Simakou T, Butcher JP, Reid S,et al. Alopecia areata: A multifactorial autoimmune condition. J Autoimmun. 2019; 98:74-85.

Arousse A,Boussofara L,Mokni S, et al. Alopecia areata in Tunisia: epidemio-clinical aspects and comorbid conditions.A prospective study of 204 cases. Int J Dermatol. 2019;58:811-5.

Yang S, Yang J, Liu JB, Wang HY, Yang Q, Gao M, Liang YH, Lin GS, Lin D, Hu XL, Fan L, Zhang XJ. The genetic epidemiology of alopecia areata in China. Br J Dermatol. 2004;151(1):16-23.

doi:10.1111/j.1365-2133.2004.05915.x. PMID: 15270868.

Dias SE,Panicker VV, Thomas J, et al. Trichoscopic features in diagnosis of alopecia areata and its relation to severity of alopecia tool (SALT) score. J Pak Assoc Dermatol. 2018;2:152-156.

Ferreira SB, Scheinburg M,Steiner D, et al. remarkable improvement of nail changes in alopecia areata universalis with 10 months treatment of tofacitinib: A case report. Case Rep Dermatol. 2016;8:262-6.

Pratt CH, King LE, Messenger AG,et al.Alopecia areata. Nat Rev Dis Prim. 2017; 3:1-17.

Chelidze K, Lipner SR. Nail changes in alopecia areata: an update and review. Int J Dermatol. 2018;57:776-83.

Sharma VK, Dawn G, Muralidhar S, et al. Nail changes in 1000 Indian patients with alopecia areata. J Eur Acad Dermatol Venereol. 1998;10:189–190.

Roest YBM, Van Middendorp H, Evers AWM, et al. Nail involvement in alopecia areata: A questionarre-based survey on clinical signs, impact on quality of life and review of the literature, Acta Derm Venerol. 2018;98:212-7.

Kasumagic-Halilovic E, Prohic A. Nail changes in alopecia areata: frequency and clinical presentation. J Eur Acad Dermatol Venereol. 2009;23:240–1.

Sharma VK, Dawn G, Kumar B. Profile of alopecia areata in Northern India. Int J Dermatol. 1996;35:22-7.

Sharma VK, Kumar B, Dawn G. A clinical study of childhood alopecia areata in Chandigarh, India. Pediatr Dermatol. 1996; 13:372-7.

Shim J, Park J, Abudureyimu G, et al. Comparative Spatial Transcription and Single-Cell Analyses of Human Nail Units and Hair Follicles Shows Transcriptional Similarities between the Onychodermis and Follicular Dermal Papilla. J Invest Dermatol. Epub ahead of print 16 Julu 2022.DOI: 10.1016/J.JID.2022.06.022.

van der Velden HM, Klaassen KM, van de Kerkhof PC, Pasch MC. Fingernail psoriasis reconsidered: a case-control study. J Am Acad Dermatol. 2013;69:245–52.

Lundin M, Chawa S, Sachdev A, et al. Gender differences in alopecia areata. J Drugs Dermatol. 2014;13:409–13.

Gandhi V, Baruah MC, Bhattacharaya SN. Nail changes in alopecia areata: incidence and pattern. Indian J Dermatol Venereol Leprol. 2003;69:114–5.




How to Cite

Asgher R, Ghania Shahid, Naima luqman, Amara Amin. Nail involvement in alopecia aereata: A descriptive cross sectional study. J Pak Assoc Dermatol [Internet]. 2023Jul.2 [cited 2024Jul.13];33(2):614-8. Available from:



Original Articles

Similar Articles

1 2 > >> 

You may also start an advanced similarity search for this article.