Gunawan Hendra, Hidayah Risa Miliawati Nurul, Achdiat Pati Aji, Maharani Retno Hesty, Yulianti Fitri
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
Clin Cosmet Investig Dermatol. 2025 Apr 29;18:1019-1032. doi: 10.2147/CCID.S506336. eCollection 2025.
Nail abnormalities can be found in patients with scabies. It is commonly misdiagnosed as onychomycosis, traumatic nail disease, or nail psoriasis. Nail changes in patients with scabies are a result of the mites burrowing activity into the stratum corneum of the epidermis, which can extend to the subungual skin of the nail. There are limited studies that have been reported regarding the incidence of nail changes in patients with scabies.
To systematically review nail abnormalities in patients with scabies reported in the literature.
We searched all published articles in electronic databases until August 2024 reporting patients with scabies with detailed descriptions of malformed/diseased nails using specific terms and inclusion/exclusion criteria. This systematic review presents the data as a descriptive analysis.
We included 32 articles reporting 33 individual patients with nail scabies. There was no significant difference in the number of scabies patients with nail abnormalities in the children (33.33%), adults (30.30%), and elderly groups (36.36%). The youngest age recorded was four months and the oldest of 92 years. Scabies were more frequent in males (60.61%). According to scabies type, 81.82% of cases of scabies with nail abnormality were crusted scabies. The most prevalent diagnosis approach was direct microscopy (84.84%), followed by histopathological examination (30.30%) and dermoscopy (12.12%). Subungual hyperkeratosis (60.60%), onychodystrophy (48.48%), discoloration (33.33%), and onycholysis (21.21%) constituted the majority of nail abnormalities. Fingernail involvement occurred in 33.33% of the patients, while combined fingernail and toenail involvement occurred in 30.30% of the patients.
Subungual hyperkeratosis, onychodystrophy, and discoloration are the most frequent nail abnormalities found in patients with scabies. In order to provide scabies patients with adequate treatment, regular nail examinations should be performed, and further prospective studies are required to completely understand the association between risk factors and abnormalities of the nail in scabies patients.
疥疮患者可出现指甲异常。它常被误诊为甲癣、外伤性指甲疾病或指甲银屑病。疥疮患者的指甲变化是螨虫钻入表皮角质层的结果，这种活动可延伸至指甲的甲下皮肤。关于疥疮患者指甲变化发生率的报道研究有限。
系统回顾文献中报道的疥疮患者的指甲异常情况。
我们检索了截至2024年8月在电子数据库中发表的所有文章，这些文章报告了疥疮患者，并使用特定术语以及纳入/排除标准对畸形/患病指甲进行了详细描述。本系统评价以描述性分析的形式呈现数据。
我们纳入了32篇报告33例指甲疥疮患者的文章。儿童（33.33%）、成人（30.30%）和老年组（36.36%）中患有指甲异常的疥疮患者数量无显著差异。记录的最年轻年龄为4个月，最年长年龄为92岁。疥疮在男性中更为常见（60.61%）。根据疥疮类型，81.82%的伴有指甲异常的疥疮病例为结痂性疥疮。最常用的诊断方法是直接显微镜检查（84.84%），其次是组织病理学检查（30.30%）和皮肤镜检查（12.12%）。甲下角化过度（60.60%）、甲营养不良（48.48%）、变色（33.33%）和甲剥离（21.21%）构成了指甲异常的主要类型。33.33%的患者手指甲受累，30.30%的患者手指甲和脚趾甲同时受累。
甲下角化过度、甲营养不良和变色是疥疮患者最常见的指甲异常。为了给疥疮患者提供充分的治疗，应定期进行指甲检查，并且需要进一步的前瞻性研究来全面了解疥疮患者指甲异常与危险因素之间的关联。
