Nail changes in pemphigus vulgaris

Habibi, Mehdi; Mortazavi, Hossein; Shadianloo, Shervin; Balighi, Kamran; Ghodsi, Saeed; Daneshpazhooh, Maryam; Valikhani, Mahin; Ghassabian, Akhgar; Pooli, Aydin; Chams‐Davatchi, Cheyda

doi:10.1111/j.1365-4632.2008.03796.x

Cited by 35 publications

(30 citation statements)

References 18 publications

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“…PV'de tırnak tutulumu akut ve kronik paronişi, onikomadezis, Beau çizgileri, subungual hemoraji, subungual hiperkeratoz, trakionişi, pitting, sarı renk değişikliği ve onikolizis şeklinde görülebilir. PV'de paronişi ve onikomadezis en sık saptanan tırnak bulgularıdır 10 . PV'li olgularımızın %11,4'ünde onikomadezis mevcuttu.…”

Section: Discussionunclassified

Konya ilinde büllöz hastalıklar: 93 olgu üzerine bir çalışma

Daye¹,

Mevlitoğlu²,

Esener³

2013

TURKDERM

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ÖzetAmaç: Büllöz hastalıklar; deri ve mukozaları tutan, doku adezyon moleküllerine karşı spesifik antikorlarla gelişen ya da genetik kalıtımın neden olduğu bir grup hastalıktır. Ülkemizde bu hastalıkları inceleyen detaylı epidemiyolojik çalışma sınırlıdır. Bu amaçla Orta Anadolu'da Konya yöresi ve civarında yaşayan büllöz hastalığı olan olguların demografik, klinik, immünopatolojik, tedavi ve takiplerindeki özellikleri sunmaktayız. Gereç ve Yöntem: Çalışmamızda 2006-2012 yılları arasında büllöz hastalık tanısıyla takip edilmiş olan 93 olgunun verileri retrospektif değerlendirildi. Olgularımızın çoğunluğu pemfigus ve büllöz pemfigoid grubunda olduğu için onlara ait veriler daha detaylı irdelendi. Bulgular: Çalışmaya dahil edilen 93 olgunun 50'si (%53,8) kadın, 43'ü (%46,2) erkekti. Yaş ortalaması 52,9 yıldı. Olgulardan %37,6'sı pemfigus vulgaris, %34,4'ü büllöz pemfigoid, %15'i herediter epidermolizis bülloza, %4,3'ü dermatitis herpetiformis, %4,3'ü pemfigus foliaseus, %2,2'i pemfigus vegetans, %1,1'i Hailey-Hailey hastalığı %1,1'i skatrisyel pemfigoid tanısı almıştı. Pemfigus vulgarisin ortaya çıkış yaş ortalaması 45,9 yıldı ve kadınlarda daha fazla görüldü. Pemfigus vulgarisli olgularda hastalık oral mukozadan başladı ve diğer coğrafik bölgelere göre; oral mukoza tutulumu ile başlayan pemfigus vulgarisli olgularda tanı alma süresi daha uzundu. Büllöz pemfigoidin ortaya çıkış yaş ortalaması 70 yıldı ve kadınlarda daha fazla görüldü. Olguların %12,5'inde hastalık oral mukozadan başladı. Hiçbir olguda eşlik eden otoimmün hastalık saptanmadı. Doksan üç olgunun 25'ine sadece sistemik steroid, 41'ine sistemik steroid ve adjuvan, 11'ine sadece adjuvan, 16'sına sadece lokal tedaviler verildi. Sum maryBackgroundandDesign:Bullous diseases are a group of disorders caused by specific antibodies against tissue adhesion molecules in the skin and mucosa or by genetic inheritance. There are limited detailed epidemiological studies about bullous disorders in Turkey. In this study, we evaluated the demographic, clinical and immunopathological findings as well as course of the disease and follow-up properties in patients with bullous disorders in the Province of Konya. MaterialsandMethods:Ninety-three patients, who were followed up between 2006 and 2012, were included in our study. Since most of the patients were in pemphigus and bullous pemphigoid groups, we investigated data on those patients in more detail. Results:53.8% of patients were female and 46.2% were male. The mean age was 52.9. 37.6% of patients had pemphigus vulgaris, -34.4% bullous pemphigoid, -15%hereditary epidermolysis bullosa, -4.3% dermatitis herpetiformis, -4.3% pemphigus foliaceus, -2.2% pemphigus vegetans, -1.1% Hailey-Hailey disease, and 1.1% of patients had cicatricial pemphigoid. The mean age of onset of pemhigus vulgaris was 45.9

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Section: Discussionunclassified

Konya ilinde büllöz hastalıklar: 93 olgu üzerine bir çalışma

Daye¹,

Mevlitoğlu²,

Esener³

2013

TURKDERM

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“…Nail involvement in pemphigus vulgaris (PV) is not rare. Paronychia is the most common nail manifestation of PV, although discoloration of the nail plate, Beau's lines, severe nail dystrophy, onychomadesis (nail shedding), and even total destruction of the nail plate can occur (74)(75)(76)(77). Nail changes occasionally precede skin findings and often relapse just before generalized disease exacerbation (73).…”

Section: Nail Involvement In Autoimmune Bullous Disordersmentioning

confidence: 99%

“…A recent prospective study involving 79 patients with PV showed nail changes in 34.2% of the patients (72). Subungual bullae are often hemorrhagic and can cause nail bed detachment leading to onycholysis, subungual hemorrhages, and subungual hyperkeratosis (77,78). Severe nail changes are often associated with extensive and severe skin involvement.…”

Section: Nail Involvement In Autoimmune Bullous Disordersmentioning

confidence: 99%

Treatment of inflammatory nail disorders

Dehesa

Tosti

2012

Dermatol Ther

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This article provides an updated review on diagnosis and treatment of inflammatory nail disorders including psoriasis, lichen planus, trachyonychia, and autoimmune bullous disorders. Despite the significant negative repercussion of the nail psoriasis in the quality of life of patients, treatment is often not sufficiently effective. The efficacy of topical therapies is limited to nail bed psoriasis. Intralesional corticosteroid injections are extensively utilized in nail matrix psoriasis. Systemic immunosuppressant drugs such as methotrexate and cyclosporine have shown efficacy. Biologics, particularly infliximab and etanercept, have also demonstrated high efficacy in the treatment of severe nail disease. Nail matrix lichen planus can cause nail atrophy and irreversible nail scarring and requires prompt treatment with systemic steroids. There is not gold standard therapy for trachyonychia, but in most cases the nail signs improve spontaneously and treatment is not necessary. Nail changes in pemphigus and other autoimmune disorders respond promptly to systemic therapy with steroids and immunosuppressants.

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“…Pseudopyogenic granuloma of the proximal or lateral nail fold can also be seen, and it has been reported to be the first symptom of a relapse of the disease [20]. According to Habibi et al [21], these nail changes are related to the number of skin bullae and the presence of periungual bullae. Depending on the location of acantholysis in the nail folds, different nail changes may result.…”

Section: Discussionmentioning

confidence: 99%

“…Nail matrix damage as a result of periungual inflammation results in Beau's lines, onychomadesis, onychoschizia, cross-ridging, pitting, and trachyonychia. Habibi et al [21] noted these signs in one-third of patients with PV. Subungual bullae cause nail bed detachment with onycholysis, which is often hemorrhagic and heralds a poor prognosis in patients with PV [22].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Paronychia as a Presenting Manifestation of Pemphigus Vulgaris: A Case Report

Zawar¹,

Pawar²,

Kumavat³

2017

Skin Appendage Disord

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Nail involvement in pemphigus vulgaris (PV) is an unusual clinical finding. The most common clinical manifestations include chronic paronychia and onychomadesis. We report an adult female patient with PV who initially presented with chronic paronychia of multiple fingernails and toenails before the onset of vesiculobullous eruptions. Later on, after complete resolution, there was recurrence of pemphigus presenting as hemorrhagic paronychia of the left index finger. Systemic treatment with corticosteroids and azathioprine led to complete resolution of mucocutaneous lesions as well as nail manifestations. Thus, chronic treatment-resistant paronychia may be an early and important sign of generalized pemphigus in certain patients.

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Nail changes in pemphigus vulgaris

Abstract: Nail changes in PV are common and related to the number of skin bullae and the presence of periungual bullae.

Cited by 35 publications

References 18 publications

Konya ilinde büllöz hastalıklar: 93 olgu üzerine bir çalışma

Konya ilinde büllöz hastalıklar: 93 olgu üzerine bir çalışma

Treatment of inflammatory nail disorders

Recurrent Paronychia as a Presenting Manifestation of Pemphigus Vulgaris: A Case Report

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