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Nail changes in pemphigus: a systematic review and meta-analysis.

Clara X Ng1, Nicole Lau Xer Min1, Ellie Ci-En Choi2

  • 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

International Journal of Dermatology
|June 18, 2024
PubMed
Summary

Nail changes like paronychia and Beau's lines affect nearly 39% of pemphigus patients, potentially correlating with disease severity. These underrecognized mucocutaneous manifestations warrant further investigation for diagnostic and prognostic insights.

Keywords:
nailnail changespemphiguspemphigus foliaceouspemphigus vulgaris

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Area of Science:

  • Dermatology
  • Autoimmune Diseases
  • Clinical Research

Background:

  • Pemphigus is an autoimmune blistering disease affecting skin and mucous membranes.
  • Nail changes are observed in some pemphigus patients, with potential links to disease severity.

Purpose of the Study:

  • To determine the prevalence of nail changes in pemphigus patients.
  • To characterize the types and temporal relationships of nail manifestations.
  • To explore potential correlations between nail changes and disease severity.

Main Methods:

  • Systematic review and meta-analysis of studies from 1990-2023.
  • Searched databases: Cochrane, MEDLINE, EMBASE, LILACS.
  • Included 14 studies with 1,208 patients; assessed risk of bias.

Main Results:

  • Pooled prevalence of nail disease in pemphigus was 38.9%, with high heterogeneity.
  • Paronychia and Beau's lines were the most frequent changes.
  • Prevalence was 34.2% in pemphigus foliaceous and 39.6% in pemphigus vulgaris.

Conclusions:

  • Nail changes are common in pemphigus, particularly pemphigus vulgaris and foliaceous.
  • These manifestations may be underrecognized and have diagnostic/prognostic implications.
  • Further research is needed to clarify the correlation with overall disease course.