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Nail involvement in pemphigus vulgaris
L Engineer1, L A Norton, A R Ahmed
1Harvard School of Dental Medicine, and the Department of Dermatology, Boston University School of Medicine, MA 02115, USA.
Journal of the American Academy of Dermatology
|August 23, 2000
Summary
Nail involvement, though rare in pemphigus vulgaris, can signal severe disease flares. Systemic therapy effectively manages skin, oral, and nail symptoms, often leading to complete nail recovery.
Area of Science:
- Dermatology
- Autoimmune Blistering Diseases
Background:
- Pemphigus vulgaris (PV) is a rare autoimmune disease affecting skin and mucous membranes.
- Nail involvement in PV is uncommon but can be a significant clinical sign.
Observation:
- A severe case of PV with extensive skin and oral lesions presented with acute nail involvement.
- Hemorrhagic paronychia affecting all four extremities preceded an exacerbation of PV.
Findings:
- Literature review indicates nail involvement in PV manifests variously, commonly as chronic paronychia or onychomadesis.
- Nail changes often appear at disease onset, before a flare, or concurrently with severe disease activity.
Implications:
- Nail involvement in PV suggests disease severity and warrants systemic treatment.
- Systemic therapy is crucial for managing nail and mucocutaneous manifestations of PV.
- Complete nail recovery is typical following effective systemic treatment.