A Clinico-Histopathological Study of Nail Dermatoses in a Tertiary Care Hospital

Introduction Nail disorders account for an important component of all dermatological conditions. Nail abnormalities can result from local pathology or systemic diseases. Pathologies can lead to pain and impaired fine touch and are aesthetically distressing. Clinical assessment of nail pathologies is seldom accurate; moreover, the limited available investigative modalities make it difficult to correctly diagnose the disorders. Nail biopsies provide crucial histological information, especially for nail-limited dermatoses, though they are infrequently used and technically challenging. Proper biopsy techniques are vital to avoid complications like nail dystrophy and to ensure accurate diagnoses and effective treatments. Materials and methods A cross-sectional and observational study was conducted in the Dermatology Department of a tertiary care hospital in Maharashtra from November 2022 to July 2024, involving 51 patients aged 8-80 years with undiagnosed nail dermatoses. Patients with bleeding disorders, anesthesia allergies, and peripheral vascular diseases were excluded. Ethical clearance and written consent were obtained. In the case of pediatrics, patients' parental consent was obtained. Observation and results The age of the patients ranged from eight to 74 years, with a mean age of 38.04 years. The most affected age groups were 20-29 and 30-39 years old. Nineteen (37%) were manual laborers, followed by 10 (20%) students and nine (18%) professional workers. Symptoms lasted from one month to eight years, with a mean duration of 16.65 months. The most common dermatoses diagnosed clinically were as follows: 18 (35.3%) were onychomycosis, 16 (31.4%) were psoriasis, and eight (15.7%) were lichen planus. However, on histopathology, 20 (37.2%) were onychomycosis, followed by 16 (31.4%) of psoriasis, and eight (15.7%) were lichen planus. Conclusion This study highlights the critical role of nail biopsies in diagnosing nail disorders, particularly among middle-aged males who were manual laborers by occupation. It underscores the importance of combining clinical and histopathological approaches to accurately diagnose and manage, advocating for continued research and collaboration to improve patient outcomes.