The Association Between Nail Involvement and Disease Severity in Patients with Pemphigus - A Retrospective Study
Zeynep Altan Ferhatoğlu, Gürbüz YıldırımDepartment of Dermatology and Venerology, Cerrahpasa Faculty of Medicine, Istanbul University Cerrahpasa, Istanbul, TürkiyeINTRODUCTION: Pemphigus, a group of chronic, potentially fatal mucocutaneous bullous disorders, often presents with limited evidence of nail involvement. This study investigated the relationship between nail manifestations and disease severity in patients with pemphigus.
METHODS: We conducted a meticulous retrospective review of medical records of 18 patients (9 males, 9 females) diagnosed with pemphigus, focusing on patients with and without nail manifestations. We documented a comprehensive set of demographic and clinical parameters, including the nature of the nail involvement. Disease severity was evaluated using the Pemphigus Disease Area Index (PDAI).
RESULTS: Of the 18 participants, 8 exhibited nail involvement, with an equal gender distribution. Pemphigus vulgaris was the predominant type, diagnosed in 14 patients, followed by pemphigus foliaceus in 4 patients. Nail manifestations included involvement of both the finger and toenails, most commonly presenting as paronychia, onychomadesis, and nail discoloration.
DISCUSSION AND CONCLUSION: As pemphigus is a life-threatening group of diseases, monitoring its effects and follow-up are crucial. Even though nail involvement is often dismissed as a rare manifestation, it could potentially serve as a significant prognostic indicator for pemphigus. We believe that conducting larger-scale studies could offer invaluable insights into the prognosis and disease duration among pemphigus patients with nail involvement.
Manuscript Language: English