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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
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.
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.
