The nail fold in pemphigus vulgaris

Nail changes in pemphigus vulgaris

“…11,13,15 In most patients with PV, nail involvement improves with clearance of the skin and mucosal lesions. 6,7,11,12 In this study, we did not perform nail bed biopsy and DIF, because all of our patients had a positive skin DIF for PV, and previous studies have shown the presence of immunoglobulin G (IgG) autoantibodies and C3 in uninvolved skin of patients with PV and pemphigus foliaceus. 16,17 In our study, as in that of Schlesinger et al ., 7 nail changes were much more common than expected in patients with PV.…”

“…6,7 Other nail changes in PV include Beau's lines, onycholysis, nail dystrophy, onychorrhexis, subungual hemorrhage, subungual hyperkeratosis, trachonychia, and longitudinal ridging. [6][7][8][9][10][11][12][13][14][15] Nail involvement can be part of the initial presentation of PV, [8][9][10][11][12] can herald the exacerbation of the disease, 13,14 or may be concomitant with flare-up of the disease. 11,13,15 In most patients with PV, nail involvement improves with clearance of the skin and mucosal lesions.…”

Nail Destruction in Pemphigus vulgaris

“…Other nail changes include onycholysis [1, 3], trachyonychia [3], longitudinal ridging [3]and nail plate discoloration [2, 3]. Haemorrhagic paronychia [2, 4], subungual and intra-ungual haemorrhages can also be observed [5, 6]. Beau’s lines may appear after each pemphigus flare [7].…”

Treatment of inflammatory nail disorders

“…When the ventral nail fold is affected, bullae are not visible and the clinical manifestations resemble those of chronic paronychia, with periungual inflammation, erythema, exudation, loss of the cuticle, and crusting around the nail fold. Subungual bullae are often hemorrhagic and can cause nail bed detachment leading to onycholysis, subungual hemorrhages, and subungual hyperkeratosis (77,78). In contrast, when the dorsal nail folds are affected, patients present with bullous lesions and acute periungueal inflammation, often hemorrhagic.…”