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. 2019 Nov;5(6):362-365.
doi: 10.1159/000501228. Epub 2019 Aug 27.

Nail Involvement during Pemphigus

Bouchra Baghad  1 , Soumiya Chiheb  1
Affiliations

Nail Involvement during Pemphigus

Bouchra Baghad et al. Skin Appendage Disord. 2019 Nov.

Abstract

Background: Pemphigus is an autoimmune bullous disease affecting the skin and mucous membranes. Associated nail involvement is underestimated and is characterized by a variety of clinical manifestations. Our aim was to describe the clinical aspects of nail involvement during pemphigus.

Patients and methods: A retrospective study was conducted of patients with pemphigus over a period of 12 years. The diagnosis of pemphigus was based on clinical and immunopathological data. Clinical data were collected from patient records prior to initiation of treatment.

Results: Overall,141 cases of pemphigus were collected. Of these, 60 patients had nail involvement. After eliminating fungal origin, we selected 37 patients in our study. The main clinical forms were paronychia and dystrophy. Two cases of destruction of the nail apparatus were found in patients with pemphigus vegetans. The disease was bilateral in 11 cases (29.7%). The presence of ungual involvement was correlated with severity of pemphigus, particularly severe oral disease (p = 0.002).

Conclusion: Nail lesions were polymorphic in our patients. These signs show accumulated inflammation of the nail after a long evolution of the disease. Nail involvement may precede, be concomitant, or follow the mucocutaneous lesions of pemphigus and be a sign of severity or relapse of the disease.

Keywords: Desmoglein 1; Desmoglein 3; Nails; Paronychia; Pemphigus.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Clinical aspects of nail lesions in pemphigus. a Beau's lines and onycholysis. b–d Paronychia. e Periungual blister. f Paronychia and ungual dystrophy.
Fig. 2
Fig. 2
Nail involvement during pemphigus vegetans.
Fig. 3
Fig. 3
Distribution of lesions among fingers and toenails.
See this image and copyright information in PMC

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