Supplementary Material for: Nail Involvement in Refractory Pediatric Alopecia Areata: A Duration-Dependent Finding

This study examined nail involvement in 91 children with treatment-resistant alopecia areata (AA), aged 3.5–14 years. It found that 69.2% of these children had nail involvement, with pitting being the most common feature (74.6%). Nail involvement was significantly associated with longer disease duration (p=0.049) but not with the severity of scalp hair loss (p>0.05). Additionally, children without a family history of AA experienced more severe disease and a higher incidence of alopecia totalis or universalis (p<0.05). The findings suggest that nail-matrix autoimmune activity may progress independently of scalp severity in refractory pediatric AA cases.