A clinical study of nail changes in papulosquamous disorder

Amutha, A (2018) A clinical study of nail changes in papulosquamous disorder. Masters thesis, Coimbatore Medical College, Coimbatore.


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BACKGROUND AND PURPOSE OF STUDY: Nails have both functional as well as aesthetic importance. Despite being a small anatomical unit it is afflicted by a variety of diseases. Papulosquamous disorder is a heterogeneous group of diseases, whose nosology is based on the morphology of clinical lesions which is dominated by scaly papules and plaques. The major diseases included in this group are psoriasis, parapsoriasis, lichen planus, lichen nitidus, lichen striatus, pityriasis rosea, pityriasis rubra pilaris, parapsoriasis and pityriasis lichenoides which are characterised by skin and nails lesions. Nail changes in papulosquamous disorder have been inadequately discussed and only limited studies are present. This study aims to throw some light about frequency of nail involvement in papulosquamous disorders and its various patterns. METHODOLOGY: All patients with papulosquamous disorders diagnosed clinically as per ICD 10 Classification attending the OPD in our Department, from June 2016 to June 2017 were included in the study. Each patient underwent detailed dermatological examination with special attention to nail, after obtaining informed consent. Then a detailed history including age of onset, duration of disease and any relevant co- morbid illness were obtained. General, systemic and dermatological examinations were done. Nails were examined in detail. Routine blood investigations like CBC, LFT, and RFT were done for needed patients. Special investigations like skin biopsy and potassium hydroxide (KOH) mount was done in relevant cases. RESULT: There were 104 cases of papulosquamous disorder with a male to female ratio of 1.2 : 1 found. Most of the cases belonged to the age group of 31-45 years. The most common papulosquamous disorder was psoriasis, followed by lichen planus and PRP. The least common were PLC and Parapsoriasis. 61.5% had nail changes. Out of these the most common nail change observed was pitting (51.9%), followed by subungual hyperkeratosis and least common was pterygium. Average number of nail involvement was maximum for psoriasis followed by PRP. 7.8% of patients had associated onychomycosis. 10.6% of psoriasis patients had associated joint involvement. Concomitant associations with atopy (18.8% ), diabetes mellitus (9.4%) and systemic hypertension (13.2%) were seen among the patients with papulosquamous disorder. CONCLUSION: The clinical significance of nail changes in association with the papulosquamous disorders is established beyond doubt. Particular localization of specific pattern enables the clinician to differentiate between various papulosquamous disorders. Correlation of the nail changes helps dermatologist to reach conclusive diagnosis and thus assist in early diagnosis and effective management.

Item Type: Thesis (Masters)
Uncontrolled Keywords: papulosquamous disorders ; psoriasis nail changes ; lichen planus nail changes.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 19 Jul 2018 04:06
Last Modified: 19 Jul 2018 04:06
URI: http://repository-tnmgrmu.ac.in/id/eprint/8915

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