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العنوان
Evaluation of Subclinical Nail changes in Patients with chronic Plaque Psoriasis using Dermoscopy /
المؤلف
Attia, Rana Omar Mohamed.
هيئة الاعداد
باحث / Rana Omar Mohamed Attia
مشرف / Mohamed Abdelnaeem Sallam
مشرف / Khaled Mohamed Abd El-Raouf El-Zawahry
مناقش / Khaled Mohamed Abd El-Raouf El-Zawahry
تاريخ النشر
2018.
عدد الصفحات
179 P. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الأمراض الجلدية
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم الامراض الجلدية
الفهرس
Only 14 pages are availabe for public view

from 179

from 179

Abstract

Dermoscopy is a non-invasive technique that allows the visualization of subtle clinical features of the skin surface and appendages details not visible to the naked eye, allowing magnifications of up to 200x. It is widely used for evaluating and diagnosing all nail diseases, as it provides important information. As any other examination, nail dermoscopy (onychoscopy) requires a good knowledge of nail anatomy & physiology and the pathogenesis of the nail diseases, and it is helpful for the diagnosis of numerous nail diseases and tumors.
Nail disorders are defined according to their appearance and the part of the nail affected (from distal to proximal): hyponychium, onychodermal band (ODB), nail bed, nail plate, lateral nail folds (perionychium), lunula (distal part of the matrix), cuticle, nail matrix and proximal nail fold.
All nail disorders can be observed by dermoscopy. Dermoscopic features of nail signs are always very interesting and saving, and may help in understanding nails diseases.
Psoriasis is a chronic, inflammatory, skin disorder that causes a considerable degree of morbidity and mortality. The severity of psoriasis may vary from mild localized distribution to more severe erythrodermic forms.
Although, skin involvement is the most commonly encountered form of psoriasis, nail involvement represents a recognizable feature of chronic psoriasis. Nail psoriasis can occur in up to 50% of psoriasis patients, Only 5–10% of nail psoriasis cases are thought to occur in the absence of cutaneous disease. Nail psoriasis leads to impairment in the quality of life due to aesthetic concerns as well as limitations in daily activities resulting from the associated pain.
The objective of this thesis was to study the dermoscopic findings of subtle nail changes in patients with chronic plaque psoriasis and compare it with that nail changes in healthy controls by both polarized and non polarized mode of dermoscope, aiming to assist clinicians in correctly evaluating and diagnosing nail changes with the help of dermoscopy.
We conducted a comparative descriptive study on 50 patients having chronic plaque psoriasis, 26 were males (52.0%) and 24 were females (48.0%), as well as 50 normal healthy control subjects, 31 were males (62.0%) and 19 were females (38.0%). Patients and controls were randomly recruited from the outpatient clinic of dermatology department at Ain Shams University Hospitals, during the period from February 2018 till September 2018. And the age of both groups ranged from 14 to 70 years.
Our study revealed that the most common fingernail changes found in psoriatic patients were nail plate thickening and crumbling followed by Dilated nailbed capillaries at the onychodermal band, Oncholysis, Subungual hyperkeratosis, Pitting, Longitudinal ridges, Scales, Salmon patch, Leukonychia, Splinter hemorrhage, Lunula red spot and Trachyonychia.
And the most common toenail changes found in psoriatic patients were Subungual hyperkeratosis followed by Nail Plate Thickening &Crumbling, Oncholysis, Pitting, Longitudinal ridges, Scales, Salmon patch, Trachyonychia, Dilated nailbed capillaries at the onychodermal band, Splinter hemorrhage, Leukonychia and Lunula red spot.
We found there was no difference between polarized and non polarized mode of dermoscope in examination of fingernails and toenails except that the non polarized mode showed the changes of the Dilated capillaries at the onychodermal band more obviously. And also, there was no difference between wet and dry method of polarized mode of dermoscope.
We also found that the nail changes were related to the duration of psoriasis as there was significant difference between the duration of psoriasis and the presence of nail changes as pitting and nailplate thickening & crumbling in fingernails and pitting in toenails.
Our study revealed that the presence of nail changes were not affected by the severity of psoriasis which was assessed by PASI score except for the pitting which was more in cases of moderate and sever PASI score.
Our study also revealed that the presence of nail changes were not affected by psoriasis in hand and foot except for the presence of Scales and Nailplate thickening &crumbling in fingernails and the presence of Scales only in toenails.
We also hypothesize that nail changes associated with psoriasis may be due to many factors such as genetics, occupation, enviromental and minor traumas.
Finally, this study confirms that the handheld dermoscope is a very efficient and simple tool for detection of any nail abnormality.