title: Remarkable Improvement of Nail Changes in Alopecia Areata Universalis with 10 Months of Treatment with Tofacitinib: A Case Report.
abstract: Alopecia areata (AA) is a chronic, autoimmune disease. The main symptom is massive hair loss, localized or diffuse, in the scalp and the whole body. However, nails may also be involved, and brittleness, fragility and pitting can be signs of nail dystrophy in AA patients. Here, we report the case of a male patient with AA refractory to various treatments, including oral, topical and intralesional corticosteroids, immunosuppressants, cyclosporin and PUVA (oxoralen plus ultraviolet light), all interrupted due to side effects. The patient's nails had erythematous blotches (striated lunulae) with regular and superficial pitting as well as fragility (trachyonychia), and he could no longer play the guitar because of these symptoms. With patient consent, we introduced tofacitinib (5 mg twice daily), which resulted in remarkable improvements not only regarding hair regrowth but also nail changes, with function recovery within 10 months.
authors.affiliation: Clínica Dermatologia Dra Sineida Berbert Ferreira, Maringá, Brazil.
authors.forename: Sineida Berbert
authors.initials: SB
authors.lastname: Ferreira
authors.affiliation: Hospital Israelita Albert Einstein and Associação de Assistência à Criança Deficiente (AACD), São Paulo, Brazil.
authors.forename: Morton
authors.initials: M
authors.lastname: Scheinberg
authors.affiliation: Clínica Steiner, São Paulo, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Steiner
authors.affiliation: Clínica Steiner, São Paulo, Brazil.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Steiner
authors.affiliation: Clínica Steiner, São Paulo, Brazil.
authors.forename: Gustavo Longhi
authors.initials: GL
authors.lastname: Bedin
authors.affiliation: Unicesumar, Maringá, Brazil.
authors.forename: Rachel Berbert
authors.initials: RB
authors.lastname: Ferreira
keywords: Alopecia areata; Nails; Tofacitinib