Archive | 2019
Study of Nail Disorders in Dermatology
Abstract
Introduction: The nail disorders comprise approximately 10% of all dermatological conditions. The nail unit may reflect dermatological disorder by its own and may show specific changes that are markers for a wide range of systemic disorders. Consequently, no physical examination is complete without a study of the nails. Study objective is to record the clinical spectrum of nail disorders including congenital, developmental, infectious, neoplastic, degenerative, dermatologic and systemic diseases. Material and methods: A total of 157 patients with nail changes were studied over a period of 18 months. All cases were evaluated with detailed history and thorough examination. Investigations like potassium hydroxide mount, fungal culture, random blood sugar, skin biopsy, longitudinal nail biopsy were performed as per requirement. Results: The age group of patients ranged from 1-86 years. Majority were seen between 31 and 40 years (22.30%). Male to female ratio was 0.8:1. Finger nails were predominantly affected in 56.70%. Nail changes associated with dermatoses were observed in 45.85%. Nail changes without associated dermatoses were observed in 33.75%, amongst which, onychomycosis (45.29%) was the commonest. Of the clinically diagnosed cases of onychomycosis, 54.3% were potassium hydroxide mount positive and 51.43% were culture positive. Most common fungal isolates detected on culture were dermatophytes (34.29%). Conclusions: Psoriasis (41.66%) was the most common dermatoses associated with nail changes. Distal lateral subungual type of onychomycosis was the commonest cause of nail changes without associated dermatoses. Among dermatophytes, Trichophyton rubrum (66.67%) was the most common isolate in culture.