Nail involvement in pemphigus vulgaris.
BACKGROUND
Involvement of the nail unit in pemphigus vulgaris (PV) is thought to be rare.


OBJECTIVE
To determine the frequency of nail changes among patients with PV.


METHODS
Nail changes were recorded in patients with PV and were analysed retrospectively. Biopsies were taken from the nail bed and nail matrix for histological and immunofluorescence observations. Microscopic (potassium hydroxide) examination and fungal culture were performed.


RESULTS
Nail changes were present in 30 of 64 (47%) patients with PV. Sixteen patients had onychomycosis and 14 had nail changes due to PV. These included onychomadesis, discoloration, deformity, onychorrhexis, onycholysis, subungual haemorrhage, subungual hyperkeratosis and paronychia. Onychomycosis affected fingernails and toenails, but changes due to PV occurred only in fingernails, most commonly on the thumb and index finger. No connection was found between the patient's occupation and nail involvement, and there was no correlation with the severity or duration of PV. In a control group of 64 patients of similar sex and age, only two had non-specific fingernail changes.


CONCLUSIONS
Nail changes in PV may be more frequent than previously thought.
Schlesinger
N
N
Rheumatology Service, UMDNJ/New Jersey Medical School, Newark, NJ 07103, USA.
Katz
M
M
Ingber
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000032:analysis; D005260:Female; D006229:Hand Dermatoses / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000276:immunology / Q000473:pathology*; D014009:Onychomycosis / Q000150:complications; D009894:Opportunistic Infections / Q000150:complications; D010392:Pemphigus / Q000150:complications / Q000276:immunology / Q000473:pathology*; D012189:Retrospective Studies
D001323:Autoantibodies; D007074:Immunoglobulin G