Epidemiology and Trends of Nail Disorders (2014-2024): A Single Tertiary-Center Study

Introduction: Nail disorders encompass a wide range of conditions affecting individuals across all age-groups. The aim of the study was to evaluate the workload and trends of nail-related visits (NRVs) in a tertiary outpatient dermatology clinic over a 10-year period.

A retrospective review was conducted of all NRVs to the dermatology outpatient clinic at Sheba Medical Center between January 1, 2014, and February 29, 2024.

A total of 9,064 NRVs were recorded among 4,241 patients, representing 4.8% of 189,481 total dermatology outpatient visits. The mean number of visits per patient was 2.1 (±2.1). Except for 2017 and 2022, the annual proportion of NRVs increased consistently, peaking at 6.8% in early 2024. Females accounted for 54% of NRVs, with a mean age of 44.9 years compared to 43.5 years in males (p < 0.001). Isolated toenail involvement was the most frequent presentation (71.8%). Infectious diseases were the most common category (63.2%), with onychomycosis representing 60.6% of all nail disorders. However, its relative frequency declined significantly over time. Other notable trends included significant rising rates of longitudinal melanonychia, acrylate-induced nail changes, and lateral ingrown nail. Pediatric and elderly NRVs rose significantly over the study period, whereas young adult representation declined.

NRVs represent a substantial and increasingly prominent component of dermatologic outpatient care. Shifts in diagnostic patterns, most notably a decline in onychomycosis and a rise in longitudinal melanonychia and acrylate-induced nail changes, highlight the evolving epidemiology of nail disorders.