case_images: PMC11380711_01
case_images: Nail changes observed at patient's first clinic visit:erythematous, inflammatory changes of the nail of the right 4th digit with pitting. No clinical changes of other nails observed.
case_images: CRIDM2024-8879884.001.jpg
case_images: PMC11380711_01_CRIDM2024-8879884.001.jpg
case_images: fig1
case_images: The inflammation of the digit surrounding the nail improved with tacrolimus ointment, triamcinolone lotion, clobetasol ointment, and oral fluconazole over the course of eight weeks (Figure 1).
case_images: (a) Right 4th nail dystrophy with pitting on the day trial of baricitinib was initiated. (b) Right 4th nail with normalized in texture and appearance after 11 months of treatment with baricitinib.
case_images: CRIDM2024-8879884.002.jpg
case_images: PMC11380711_01_CRIDM2024-8879884.002.jpg
case_images: fig2
case_images: The patient was started on a trial of baricitinib 4 mg tablets daily for alopecia areata, which was the suspected cause of the nail changes (Figure2(a)). Within 11 months of treatment, her nail was normalized in appearance and texture (Figure 2(b)).