Twenty-nail dystrophy of alopecia areata

Abstract

We describe here a patient with dystrophy of all 20 nails, which has persisted for five years after the resolution of alopecia areata. We feel that the term "20-nail dystrophy" is best used to describe a clinical entity that can have several causes.

Twenty nail dystrophy in association with zosteriform lichen planus

“…It can be idiopathic or may be associated with lichen planus, psoriasis, alopecia areata, ichthyosis vulgaris, eczema, vitiligo, primary biliary cirrhosis, IgA deficiency, and graft-versus-host disease. [12] Twenty-nail dystrophy has congenital, familial, and acquired forms. All nails may or may not be involved.…”