Nail Abnormalities in Subepidermal Blistering Diseases: A Cross-Sectional Study Publisher Pubmed



Vafaeian A¹ ; Ghanbarzadeh A¹ ; Daneshpazhooh M¹ ; Abedini R¹ ; Balighi K¹ ; Etesami I¹ ; Farid AS¹ ; Farimani Z¹ ; Mahmoudi L¹ ; Azar PM¹ ; Mahmoudi H¹ Show Affiliations
Source: International Journal of Dermatology Published:2023

Abstract

Background: Nail involvement in subepidermal autoimmune blistering diseases (SEABD) is not common. Although these changes can be transient, permanent changes can also occur. This study addresses nail involvement manifestations and their associated factors in patients with SEABD. Methods: From March 2020 to March 2021, we enrolled 56 patients with SEABD who were being examined at a tertiary skin hospital and checked their nail changes. We investigated the association between the SEABD subtypes and treatments that patients were receiving and the nail abnormalities. Additional factors including age, gender, duration since diagnosis, presence of mucosal involvement, and anti-bp230 and anti-bp180 IgG antibody quantitative levels (in those patients with bullous pemphigoid) were analyzed. Results: The most common nail abnormalities were ridging, onycholysis, and onychoschizia. We observed a lower prevalence of onycholysis in EBA, a lower prevalence of periungual bullae in MMP, and a higher prevalence of scarring loss in EBA. Rituximab and dapsone were effective in preventing onycholysis as well as prednisolone in preventing subungual hematoma. Multiple lesions were found to be more common in the foot digits including great toes, probably because of higher exposure to trauma. Conclusions: In summary, in patients with SEABD and concomitant nail involvement, the underlying disease control, proper treatment, and avoidance of trauma may be helpful. © 2023 the International Society of Dermatology.