Journal of Clinical & Experimental Dermatology Research
Open Access

Abstract

Dermoscopy of Nails Involvement in Autoimmune Bullous Diseases: A Case-Control Study

Eman R. M. Hofny1, Mohamed S. Hasan2, Yasmin Salah1, Yasmin M. Tawfik1*

ABSTRACT Background: Autoimmune bullous disorders can affect the skin, mucous membranes and nails. Dermoscopic nail changes in autoimmune bullous disorders either with clinically affected or subclinically affected nails have not been demonstrated up to date. Aim: To study occurrence and percentage of dermoscopic nail changes in various autoimmune bullous disorders. Materials and methods: One hundred participants were recruited in this study. Half of them (fifty patients) had different autoimmune bullous diseases and were grouped according to their nail affection into two groups, group 1: Patients with clinically affected nails, and group 2: Patients with clinically apparent normal nails (with subclinical changes). All parts of finger nails were examined by dermoscopy and were compared with fifty age and sex matched healthy volunteers. Results: Dermoscopic nail changes were observed in 88% of patients with autoimmune bullous diseases and 44% of controls. In group 1: The most frequent dermoscopic findings were onychorrhexis 52%, splinter hemorrhage 40% and onychomadesis 40% while in group 2: 24% had no dermoscopic findings, 48% had splinter hemorrhage and it was significantly higher than group 1 (p<0.001), 28% had Beaus’ lines, then onycholysis and onchomycosis 24% for each. In both groups, onychomycosis and longitudinal striations were significantly higher in those ≥ 50 years. While, in group1 only, Beau's lines and onychorrhexis were higher in those ≥ 50 years old. Also, splinter hemorrhage and periungual blister were significantly higher among those with disease duration less than 1 year in both groups. Conclusion: Signs of clinical and subclinical involvement of nails in autoimmune bullous diseases can be appreciated well with the help of the dermoscope even in clinically unaffected nails. Splinter hemorrhage, onycholysis, onychomycosis and Beaus’ lines were dermoscopic signs detected in clinically free nails so appropriate dermoscopic nail examination in patients with Autoimmune Blistering Diseases (AIBD) is mandatory to detect early nail changes where treatment should be instituted to prevent permanent damage of nails.

Published Date: 2024-06-03; Received Date: 2024-05-03