We assessed the prevalence of nail abnormalities in 272 children with
alopecia areata who were seen in our department during an eight-year p
eriod. Of these, 126 (46%; 50 girls, 76 boys) had nail abnormalities t
hat were related to alopecia areata. Nail pitting was detected in 92 p
atients, including 37 with alopecia totalis or alopecia universalis. T
hree patients experienced an onychomadesis of all 20 nails during the
acute onset of alopecia areata universalis. Thirty-two (11.7%) had nai
l thinning and severe nail plate surface abnormalities that were consi
stent with a diagnosis of trachyonychia.