Keimyung Medical Journal, Vol.9(3) : 365-368, 1990
We report a case of twenty-nail dystrophy accompanied by alopecia universalis in a 45-year old woman. She had developed dystrophic nail changes on her all finger and toe nails for 26 years and alopecia universalis for 10 years. On examination, 20 nails were affectedwith opalescent, thickening, longitudinal ridging, and total hair loss were in scalp, eyebrow, axilla, and pubic area. Mycologic study of involved nails was performed, but negative results were obtained. Histologic findings of dystrophic nails revealed prominent hyperkeratosis, acanthosis, and mild infiltration of mononucler cells in the upper dermis. The histologic findings of scalp showed a few atrophic hair follicle, thining of epidermis, and slightly hyperkeratosis. All of these clinical and histologic findings were considered as twenty-nail dystrophy accompanied by alopecia universalis. She was treated with intralesional injection of triamcinolone acetonide and topical application of dinitrochlorobenzene, but no significant improvement was made. The further observation is being conducted.