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Onychomycosis in patients with psoriasis--a multicentre study
L Zisova1, V Valtchev, E Sotiriou
1Dermatology and Venereology, Medical University Plovdiv, Plovdiv, Bulgaria. lzisova@abv.bg
Mycoses
|July 21, 2011
Summary
Psoriasis patients frequently develop nail deformities, increasing their risk of fungal infections like onychomycosis. Mycological examination is crucial for diagnosing these common nail conditions in psoriasis patients.
Area of Science:
- Dermatology
- Mycology
- Clinical Medicine
Background:
- Psoriasis affects 1-3% of the population, with nail disorders occurring in 10-80% of cases.
- Nail psoriasis manifestations include pitting, Beau's lines, hyperkeratosis, onycholysis, leuconychia, and oil drops.
- Onychomycosis is a common fungal nail infection caused by dermatophytes, yeasts, and molds.
Purpose of the Study:
- To investigate the prevalence of onychomycosis in patients with psoriasis.
- To determine the etiological agents of onychomycosis in this patient group.
- To assess the correlation between nail psoriasis severity and fungal infection.
Main Methods:
- Examined 228 psoriasis patients (aged 18-72) from Bulgaria and Greece.
- Nail samples analyzed via direct microscopy (20% KOH) and Sabouraud agar culture.
- Nail Psoriasis Severity Index (NAPSI) used to quantify nail disorder severity.
Main Results:
- Positive mycological cultures obtained in 62% of psoriasis patients.
- Dermatophytes were the most common cause (67%), followed by yeasts (24%) and molds (6%).
- High NAPSI scores were observed in all patients; those with isolated Candida showed even higher scores.
Conclusions:
- Psoriasis patients exhibit a high prevalence of onychomycosis.
- Dystrophic nails in psoriasis are more susceptible to fungal infections.
- Obligatory mycological examination is recommended for psoriasis patients with nail deformities.
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