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Nail changes in connective tissue diseases: a study of 39 cases

Pan Afr Med J. 2014 Jun 17:18:150. doi: 10.11604/pamj.2014.18.150.4637. eCollection 2014.

Abstract

The objective is to identify nail unit changes associated with connective tissue diseases (CTD) and evaluate their frequency. We carried a prospective study between March 2012 and March2013 in our department. All patients with CTD were included. A clinical examination of the fingernails was done by the same dermatologist. Nail features were noted and classified and photos taken. Thirty nine patients were enrolled including: 16 systemic sclerosis, 14 lupus erythematosus (SLE), 8 dermatomyositis (DM), 1 primary Sjorgen's syndrome. The mean age was 40 years old. The mean duration of the disease was 6 years. Nail unit changes were present in 27 patients (69%). The abnormalities observed were Longitidunal ridging in 11 patients, Peri ungueal erythema in 10 patients, Peri-ungual telangiectasia in 11 patients, Ragged cuticle in 10 patients fingertips scars in 9 patients, Increase of longitudinal curvature and beaking of the nail in 4 patients, Increase in transverse curvature in 4 patients, dyschromia of the proximal nail fold in 3 patients, Subungual hyperkeratosis in 3 patients, onycholysis in 2 patients, splinter haemorrhages in 3 patients, nail plate pigmentation in 2 patients, pseudoclubbing in 1 patient, macrolunula in 1 patients, Red lunulae in one patient, bluish-black discoloration of the nail plate in one patient. The proximal nailfold was found to be most sites affected.

Keywords: Nail changes; Periungueal telangiectasia; connective tissue diseases; fingertips scars; longitudinal ridging; nail fold; peri ungueal erythema; ragged cuticle.

MeSH terms

  • Adult
  • Cohort Studies
  • Connective Tissue Diseases / complications
  • Connective Tissue Diseases / epidemiology*
  • Dermatomyositis / complications
  • Dermatomyositis / epidemiology
  • Erythema / complications
  • Erythema / epidemiology
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / epidemiology
  • Male
  • Nail Diseases / complications
  • Nail Diseases / epidemiology*
  • Pigmentation Disorders / complications
  • Pigmentation Disorders / epidemiology
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / epidemiology
  • Sjogren's Syndrome / complications
  • Sjogren's Syndrome / epidemiology