Clinico-epidemiological profile and onychoscopic pattern of nail disorders in geriatric population

Gajendra Muzalda, K. Bhatia, C. Namdeo
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Abstract

Background: Adequate knowledge about nail changes in the geriatric population can help in the early identification and timely treatment of underlying disease adding to the quality of life of the elderly population with nail concerns. The present study is aimed to study the clinico-epidemiological profile and onychoscopic pattern of nail disorders in geriatric populations. Methods: This observational study included 100 subjects aged 60 years or more. Clinical examination and onychoscopic examination by Dermlite DL4 dermoscope with 10x magnification of the nail bed, nail plate, nail fold, and hyponychium in all the 20 nails were done. Even single positive findings in a single nail are considered in the study. If clinically suspected of onychomycosis, 20% potassium hydroxide mount was performed to identify fungal elements. Results: Mean age of the subjects was 66.27±5.546 years. Male: female ratio was 2.1:1. Mean duration of complaints pertaining to nail changes was 4.7±3.864 years. The damaged cuticles were the universal finding in all the subjects (100%) in nail fold examination, nail dystrophy and longitudinal ridges were seen in all [100.0%)] subjects of nail plate examination. The most frequently observed change in nail bed has been splinter haemorrhage [26% versus. 32%] and in hyponychium was subungual hyperkeratosis [36% versus 37.0%] clinically and dermoscopically respectively. Onychomycosis was diagnosed in 25% of total subjects. Conclusions: Onychoscopy is an important, non-invasive modality to identify and diagnose the nail changes earlier which helps in managing the disease earlier.
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老年人群甲疾病的临床流行病学特征和甲镜模式
背景:充分了解老年人群的指甲变化可以帮助早期识别和及时治疗潜在疾病,从而提高老年人群的生活质量。本研究旨在研究老年人群甲疾病的临床流行病学特征和甲镜模式。方法:本观察性研究纳入100名年龄在60岁及以上的受试者。临床检查及甲镜检查均采用Dermlite DL4型皮肤镜,10倍放大甲床、甲板、甲襞及甲下部。即使是单个钉子的单个阳性结果也被考虑在研究中。如果临床怀疑为甲真菌病,20%氢氧化钾mount进行鉴定真菌元素。结果:患者平均年龄66.27±5.546岁。男女比例为2.1:1。指甲变化的平均投诉持续时间为4.7±3.864年。甲襞检查普遍发现角质层受损(100%),甲板检查普遍发现甲营养不良和纵脊(100.0%)。甲床最常见的变化是分裂性出血[26%相比。32%],而在甲下则是指下角化过度症[36%对37.0%],分别是临床和皮肤镜检查。25%的受试者被诊断为甲真菌病。结论:甲镜检查是一种重要的、非侵入性的方法,可以早期识别和诊断甲变,有助于早期治疗。
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