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January 1981

Twenty-Nail Dystrophy of Alopecia Areata

Arch Dermatol. 1981;117(1):1. doi:10.1001/archderm.1981.01650010005001

To the Editor.—  I believe there are some misunderstandings in the articles written concerning twenty-nail dystrophy.1,2This syndrome can be classified under two main groups taking into account the luster of the nail.In the first group, there is loss of nail luster because of roughness, and there is excess longitudinal ridging.3 For this condition, we have coined the term "vertical striated sandpaper twenty-nail dystrophy."4,5In the second group, twenty-nail dystrophy shows shiny nail plates with opalescence, longitudinal ridging, and a finely stippled appearance of the nail.6Alopecia areata, which may be seen in both groups, is usually associated with a uniformly distributed sandpaper twenty-nail dystrophy.Letters will be published as space permits and at the discretion of the editor. All components of letters, including references, must be typewritten, double-spaced. Do not include more than five references and two figures in duplicate. Letters should not exceed