Baghad Bouchra, Chiheb Soumiya
Department of Dermatology Venereology, Hospital Ibn Rochd, University Hassan II, Casablanca, Morocco.
Skin Appendage Disord. 2019 Nov;5(6):362-365. doi: 10.1159/000501228. Epub 2019 Aug 27.
Pemphigus is an autoimmune bullous disease affecting the skin and mucous membranes. Associated nail involvement is underestimated and is characterized by a variety of clinical manifestations. Our aim was to describe the clinical aspects of nail involvement during pemphigus.
A retrospective study was conducted of patients with pemphigus over a period of 12 years. The diagnosis of pemphigus was based on clinical and immunopathological data. Clinical data were collected from patient records prior to initiation of treatment.
Overall,141 cases of pemphigus were collected. Of these, 60 patients had nail involvement. After eliminating fungal origin, we selected 37 patients in our study. The main clinical forms were paronychia and dystrophy. Two cases of destruction of the nail apparatus were found in patients with pemphigus vegetans. The disease was bilateral in 11 cases (29.7%). The presence of ungual involvement was correlated with severity of pemphigus, particularly severe oral disease ( = 0.002).
Nail lesions were polymorphic in our patients. These signs show accumulated inflammation of the nail after a long evolution of the disease. Nail involvement may precede, be concomitant, or follow the mucocutaneous lesions of pemphigus and be a sign of severity or relapse of the disease.
天疱疮是一种影响皮肤和黏膜的自身免疫性大疱性疾病。相关的指甲受累情况被低估，且具有多种临床表现。我们的目的是描述天疱疮患者指甲受累的临床特征。
对12年间的天疱疮患者进行了一项回顾性研究。天疱疮的诊断基于临床和免疫病理数据。临床数据收集自治疗开始前的患者记录。
总共收集了141例天疱疮病例。其中，60例患者有指甲受累。排除真菌性病因后，我们研究中选取了37例患者。主要临床类型为甲沟炎和甲营养不良。在增殖型天疱疮患者中发现2例甲器破坏。11例（29.7%）患者疾病为双侧性。指甲受累与天疱疮严重程度相关，尤其是严重的口腔疾病（P = 0.002）。
我们研究中的患者指甲病变具有多形性。这些体征表明疾病长期演变后指甲出现累积性炎症。指甲受累可能先于、伴随或晚于天疱疮的黏膜皮肤病变出现，并且是疾病严重程度或复发的一个标志。
