Study of Nail Disorders in Dermatology

ABSTRACT

Introduction: The nail disorders comprise approximately10% of all dermatological conditions. The nail unit mayreflect dermatological disorder by its own and may showspecific changes that are markers for a wide range of systemicdisorders. Consequently, no physical examination is completewithout a study of the nails. Study objective is to recordthe clinical spectrum of nail disorders including congenital,developmental, infectious, neoplastic, degenerative,dermatologic and systemic diseases.Material and methods: A total of 157 patients with nailchanges were studied over a period of 18 months. Allcases were evaluated with detailed history and thoroughexamination. Investigations like potassium hydroxide mount,fungal culture, random blood sugar, skin biopsy, longitudinalnail 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%). Maleto female ratio was 0.81. Finger nails were predominantlyaffected in 56.70%. Nail changes associated with dermatoseswere observed in 45.85%. Nail changes without associateddermatoses were observed in 33.75%, amongst which,onychomycosis (45.29%) was the commonest. Of theclinically diagnosed cases of onychomycosis, 54.3% werepotassium hydroxide mount positive and 51.43% were culturepositive. Most common fungal isolates detected on culturewere dermatophytes (34.29%).Conclusions: Psoriasis (41.66%) was the most commondermatoses associated with nail changes. Distal lateralsubungual type of onychomycosis was the commonest causeof nail changes without associated dermatoses. Amongdermatophytes, Trichophyton rubrum (66.67%) was the mostcommon isolate in culture.