To the Editor.—
I believe there are some misunderstandings in the articles written concerning twenty-nail dystrophy.1,2
This 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."4,5
In the second group, twenty-nail dystrophy shows shiny nail plates with opalescence, longitudinal ridging, and a finely stippled appearance of the nail.6
Alopecia areata, which may be seen in both groups, is usually associated with a uniformly distributed sandpaper twenty-nail dystrophy.
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