Department of Dermatology, Weill Cornell Medicine, New York, NY, USA.
Int J Dermatol. 2018 Jul;57(7):776-783. doi: 10.1111/ijd.13866. Epub 2018 Jan 10.
Nail changes are a common feature of alopecia areata (AA) and are a significant source of cosmetic disfigurement and functional impairment. This 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. Searches for peer-reviewed journal articles were conducted using the PubMed/MEDLINE database with the search terms "nail changes alopecia areata," "alopecia areata nails," and specific searches on "trachyonychia alopecia areata" and "pitting alopecia areata." Other sources of articles included the reference lists of retrieved articles. 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 coexist with or confound the diagnosis. There is limited published data on the clinical manifestations of AA-associated nail changes and therapeutic options. Larger controlled trials are necessary to guide treatment decisions.
甲改变是斑秃（AA）的常见特征，也是导致容貌受损和功能障碍的重要原因。本综述更新了 AA 患者甲改变的患病率、临床和组织病理学特征、发病机制、鉴别诊断、临床病程、预后和治疗。使用 PubMed/MEDLINE 数据库，使用检索词“nail changes alopecia areata”、“alopecia areata nails”以及特定的“trachyonychia alopecia areata”和“pitting alopecia areata”进行同行评议期刊文章的检索。文章的其他来源包括检索到的文章的参考文献列表。甲改变是 AA 的常见特征，平均患病率为 30%，可导致明显的容貌受损和功能丧失。凹陷和甲粗糙是 AA 最常见的表现，平均患病率分别为 20%和 8%。红色斑点状半月甲、甲分离和点状白甲也有报道。其他病因，如甲真菌病或扁平苔藓，可能与 AA 并存或混淆诊断。AA 相关甲改变的临床表现和治疗选择的相关数据有限。需要更大规模的对照试验来指导治疗决策。
