Coexistence of onychomycosis in psoriatic nails: A descriptive study
ABSTRACT Psoriatic nail changes predispose to onychomycosis because it becomes easier for fungi to penetrate an already compromised nail plate. Moreover, some of the psoriatic nail changes closely resemble onychomycosis.
To investigate cases of nail psoriasis for any evidence of onychomycosis.
Seventy-two patients with psoriasis were included in the study. The patients were selected from the psoriasis clinic and dermatology in-patient ward. Direct microscopic examination with 20% KOH and culture were carried out in all patients showing psoriatic nail changes. Histopathological examination with Periodic Acid-Schiff (PAS) stain was done in cases negative by KOH examination and culture.
Nail changes were seen in 66.66% (48/72) of psoriasis patients. The most common fingernail changes observed were pitting, onycholysis and subungual hyperkeratosis, and the most common toenail changes were onycholysis and subungual hyperkeratosis. Nail changes were significantly more common in males. The duration of skin lesions of psoriasis and Psoriasis Area Severity Index scores were significantly higher in patients with nail changes. Out of 48 patients with psoriatic nail change, 23 (47.91%) had investigative evidence of onychomycosis. The fungal isolates on culture were non-dermatophytic molds in nine patients (18.75%) and yeast like fungi also in nine patients (18.75%).
Coexistent onychomycosis in psoriatic nails does occur.
SourceAvailable from: Maria Mercedes Panizo[Show abstract] [Hide abstract]
ABSTRACT: Resumen Weimberger José, Chimá Leydis, Navas Trina, Panizo María. Tiña incógnita por el complejo Trichophytum rubrum: presentación de un caso en paciente usuario de esteroides de forma crónica. Salus Militiae 2013;38 (1 y 2): 12/4/2015 TIÑA INCÓGNITA POR EL COMPLEJO TRICHOPHYTUM RUBRUM: PRESENTACIÓN DE UN CASO EN PACIENTE USUARIO DE ESTEROIDE… https://salusmilitiae.wordpress.com/2015/04/02/tinaincognitaporelcomplejotrichophytumrubrumpresentaciondeuncasoenpacienteusuariodeesteroi… 2/12 La tiña incógnita (tinea ignota o incognitum) es una entidad clínica como consecuencia del diagnóstico errado de una infección por dermatofitos, debido a la expresión clínica inusual de una tiña común ante el uso de esteroides locales o sistémicos. Se realiza la descripción del caso de un paciente con diagnóstico de poliartritis crónica inadecuadamente tratada con esteroides a altas dosis, quien presentó múltiples complicaciones secundarias a su patología, y la tiña incógnita fue interpretada como una manifestación cutánea de su enfermedad de base. Palabras clave: Complejo Trichophytom rubrum, tinea corporis, tinea incognitum, tiña incognita, uso crónico de esteroides.
Article: Nail psoriasis: the journey so far.[Show abstract] [Hide abstract]
ABSTRACT: Nail involvement is an extremely common feature of psoriasis and affects approximately 10-78% of psoriasis patients with 5-10% of patients having isolated nail psoriasis. However, it is often an overlooked feature in the management of nail psoriasis, despite the significant burden it places on the patients as a result of functional impairment of manual dexterity, pain, and psychological stress. Affected nail plates often thicken and crumble, and because they are very visible, patients tend to avoid normal day-to-day activities and social interactions. Importantly, 70-80% of patients with psoriatic arthritis have nail psoriasis. In this overview, we review the clinical manifestations of psoriasis affecting the nails, the common differential diagnosis of nail psoriasis, Nail Psoriasis Severity Index and the various diagnostic aids for diagnosing nail psoriasis especially, the cases with isolated nail involvement. We have also discussed the available treatment options, including the topical, physical, systemic, and biological modalities, in great detail in order to equip the present day dermatologist in dealing with a big clinical challenge, that is, management of nail psoriasis.Indian Journal of Dermatology 07/2014; 59(4):319-33. DOI:10.4103/0019-5154.135470
Nail Psoriasis: From A to Z, First edited by Dimitris Rigopoulos, Antonella Tosti, 09/2014: chapter Ultrasound Imaging of Psoriatic Nails: pages 57-64; Springer., ISBN: 978-3-319-08809-9