Nail Changes in Pemphigus Vulgaris

Background: The frequency and types of nail changes in pemphigus vulgaris (PV) are unclear. Aim To determine the frequency and types of nail changes, and their correlation with the number of skin and periungual bullae.

Methods: Seventy-nine patients with PV, including 59 new patients and 20 patients in relapse, were entered into the study. Microscopic examination in potassium hydroxide and culture for fungus were performed on all clinically abnormal nails.

Results: Twenty-five (31.6%) of 79 patients showed nail changes, with paronychia (n = 8) and onychomadesis (n = 6) being the most common. One patient in relapse had onychomycosis. The frequency of nail changes in fingers affected by periungual bullae was significantly higher than in other fingers (P < 0.05). The number of nail changes was higher in patients with a larger number of skin bullae and in those with a longer duration of disease (P < 0.05).

Conclusions: Nail changes in PV are common and related to the number of skin bullae and the presence of periungual bullae.