Nail Changes in Patients with Hair Loss
Nail Bed Capillaroscopy
Nails are sometimes important to examine in patients with hair loss. Some autoimmune diseases produce changes in the nail plate and some produce changes in the very tiny blood vessels of the nail fold (see arrow).
Three diseases in particular are associated with changes in the tiny vessels of the nail fold - dermatomyositis, system lupus erythematosus (sometimes just called "lupus") and scleroderma. All three of these diseases can cause hair loss and may be associated with more serious internal illnesses.
I don't perform nail capillaroscopy in all my patients. However, if the patient's story has any suggestion of autoimmune association, I often perform a nail bed capillaroscopy.
This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.