Nail Abnormalities in Scabies Patients: A Systematic Review

Area of Science:

• Dermatology
• Parasitology
• Nail Diseases

Background:

• Nail abnormalities are observed in scabies patients.
• These changes are frequently misdiagnosed as onychomycosis, traumatic nail disease, or nail psoriasis.
• The mite's burrowing activity in the stratum corneum can extend to the subungual skin, causing nail alterations.

Purpose of the Study:

• To systematically review and synthesize reported nail abnormalities in patients with scabies.
• To consolidate current knowledge on the incidence and characteristics of nail changes associated with scabies.

Main Methods:

• A systematic literature search of electronic databases was conducted up to August 2024.
• Articles detailing scabies patients with malformed or diseased nails were included based on specific criteria.
• Data were analyzed using a descriptive analysis approach.

Main Results:

• 32 articles reported 33 cases of nail scabies across all age groups, with a slight male predominance.
• Crusted scabies accounted for 81.82% of cases with nail involvement.
• Common nail abnormalities included subungual hyperkeratosis (60.60%), onychodystrophy (48.48%), and discoloration (33.33%).

Conclusions:

• Subungual hyperkeratosis, onychodystrophy, and discoloration are the most frequent nail abnormalities in scabies.
• Regular nail examinations are recommended for scabies patients to ensure accurate diagnosis and treatment.
• Further prospective studies are needed to fully understand risk factors and nail abnormalities in scabies.