Twenty-Nail Dystrophy Treated with Hydroxychloroquine in a Patient with Alopecia Areata

January 2019 in “ Annals of dermatology/Annals of Dermatology ”

Soo Hyeon Bae, Seok Hwan Jang, Young Ho Won

alopecia areata twenty-nail dystrophy hydroxychloroquine systemic antifungal topical corticosteroids immunomodulatory effects inflammatory pathways AA TND Plaquenil antifungal corticosteroids

TLDR Hydroxychloroquine effectively treated twenty-nail dystrophy in a patient with alopecia areata.

A 49-year-old female with alopecia areata and twenty-nail dystrophy (TND) showed significant improvement in TND after being treated with hydroxychloroquine (200 mg/day) for 1 year, following unsuccessful treatments with systemic antifungal and topical corticosteroids. Discontinuation of hydroxychloroquine led to TND recurrence, which resolved upon re-treatment for 20 months without adverse effects. This case suggested hydroxychloroquine as an effective and safe treatment option for TND, potentially due to its immunomodulatory effects on inflammatory pathways involved in alopecia areata.

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