Cutaneous manifestations in stroke patients and their association with functional rehabilitation parameters

Stroke is a focal neurological deficit resulting from vascular lesions of the brain. Stroke-related sequale, including poor hygiene, inadequate positioning, and insufficient skin care are associated with the development of dermatological problems.

To evaluate the prevalence of cutaneous findings in stroke patients and their association with clinical characteristics and functional outcomes.

This cross-sectional study included consecutive patients aged ≥18 years with a history of stroke for at least 3 months. Clinical status was assessed using the Brunnstrom Recovery Stage (BRS) and Standardized Mini-Mental State Examination (S-MMSE), and functional outcomes using the Functional Ambulation Scale (FAS) and Barthel Index of Activities of Daily Living (Barthel ADL Index).

A total of 104 stroke patients were enrolled. The most common cutaneous findings were xerosis (76.9%), skin infections (73.1%), nail changes (71.2), hair changes (51.9%), primary dermatoses (46.2%), and pruritus (42.3%). Skin infections were observed in 76 patients (73.1%), with fungal infections being the most frequent, including tinea pedis (58.7%),tinea unguium (50%). Patients with fungal infections had lower FAS scores (2.26±1.68 vs. 2.97±1.64; p = 0.042) and shorter stroke duration (median 11vs.36 months; p = 0.034). Patients with onychomycosis also had significantly lower FAS, Barthel ADL Index, and S-MMSE scores (all p < 0.05).

Xerosis, skin infections, nail changes were identified as the most frequent cutaneous findings. Lower functional and cognitive scores were associated with fungal infections. Integrating dermatological care and hygiene protocols into stroke rehabilitation may improve care for patients with limited mobility and cognitive impairment; however longitudinal studies are needed to clarify these associations.