Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Indian J Dermatol Venereol Leprol. 2010 Nov-Dec;76(6):723. doi: 10.4103/0378-6323.72468.
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.
银屑病指甲改变易患甲真菌病，因为真菌更容易穿透已经受损的甲板。此外，一些银屑病指甲改变与甲真菌病非常相似。
调查银屑病指甲病变患者中有无甲真菌病的证据。
本研究纳入了 72 例银屑病患者。这些患者是从银屑病诊所和皮肤科住院病房中选择的。对所有表现出银屑病指甲改变的患者进行直接显微镜检查（20%KOH 和培养）。对 KOH 检查和培养阴性的病例进行过碘酸希夫（PAS）染色的组织病理学检查。
72 例银屑病患者中有 66.66%（48/72）出现指甲改变。最常见的手指甲改变是凹点、甲分离和甲下过度角化，最常见的脚趾甲改变是甲分离和甲下过度角化。指甲改变在男性中更为常见。有指甲改变的患者银屑病皮损持续时间和银屑病面积严重程度指数评分显著更高。在 48 例有银屑病指甲改变的患者中，有 23 例（47.91%）有甲真菌病的调查证据。9 例（18.75%）患者的真菌培养分离物为非皮肤丝状真菌，9 例（18.75%）患者为酵母样真菌。
银屑病指甲病变中确实存在合并甲真菌病。
