Twenty-nail dystrophy and alopecia areata in an adult male with thymoma-associated myasthenia gravis: A case report

Background

To date, there is no journal that reports the coexistence of thymoma-associated myasthenia gravis, alopecia areata, and twenty-nail dystrophy. This paper hypothesizes that the presence of thymoma increases the risk of these conditions.

Case presentation

The patient was a 37-year-old Filipino who came in for a year of history of fluctuating, but progressive, left-sided ptosis and diplopia; difficulty swallowing; dysarthria; and aspiration and symmetric proximal muscle weakness confirmed to be myasthenia gravis by abnormal repetitive nerve stimulation and the presence of thymoma on histology. Before his thymectomy, he also developed gradually worsening thinning and longitudinal ridging of all fingernails and toenails; and patches of bald areas on the scalp; diagnosed to be twenty-nail dystrophy and alopecia areata, respectively, by a board-certified dermatologist.

Conclusion

Thymoma is the possible risk factor and link for the co-occurrence of the three conditions in the present patient.