Background: Leprosy presents with varied clinical morphology, and most often the morphological pattern and distribution of lesions denote a particular spectrum of leprosy; however, it may not be correct in all the cases which can lead to under treatment and dissemination of infection, particularly, in multibacillary leprosy presenting with single skin lesion. Objective: The objective of the study was to describe cases of leprosy presenting with solitary skin lesion and to establish the spectrum by slit-skin smear (SSS) and histopathological examination of skin biopsy. Materials and Methods: A prospective study involving thirty cases of leprosy presenting with single skin lesion to the department of dermatology of a tertiary care hospital spread over 2 years. Examination of skin lesion and nerves was carried out, and details were recorded. Routine hematological and biochemical investigations were done. SSS from the lesion, both ear lobes, right elbow, left middle finger, and right middle toe and lesional biopsy was done. Bacteriological index and morphological index were calculated in all cases, and the diagnosis was correlated by histopathology. Results: Of the thirty cases studied, twenty were males (66.7%) and ten (33.3%) were females with male-to-female ratio of 2:1. The most common age group afflicted was 21–40 years (70%). Hypopigmented patch was the most common presentation 19 (63.3%) in our study. The most common site of patch was forearm in 9 (30%). Of the thirty cases, 20 (66.7%) were diagnosed as borderline tuberculoid, 9 (30%) as tuberculoid tuberculosis, and 1 (3.3%) as indeterminate leprosy. Ulnar nerve was the most common nerve involved (80%). Ten patients (33.3%) were positive and twenty (66.7%) were negative for acid-fast bacilli on SSS examination. Out of the thirty clinically diagnosed leprosy cases, 19 (63.3%) showed positive histopathological correlation. Conclusions: The presentation of borderline lepromatous leprosy and lepromatous leprosy as single skin lesion reinforces the fact that certain aspects of the host cell-mediated response and pathophysiology of this disease are still not fully understood. It illustrates the importance of SSS and biopsy in these cases as such cases are undertreated.
{"title":"Observational study of leprosy presenting with solitary skin lesion from a tertiary care hospital in South India","authors":"A. Rao, Aparna Karnam","doi":"10.4103/cdr.cdr_28_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_28_21","url":null,"abstract":"Background: Leprosy presents with varied clinical morphology, and most often the morphological pattern and distribution of lesions denote a particular spectrum of leprosy; however, it may not be correct in all the cases which can lead to under treatment and dissemination of infection, particularly, in multibacillary leprosy presenting with single skin lesion. Objective: The objective of the study was to describe cases of leprosy presenting with solitary skin lesion and to establish the spectrum by slit-skin smear (SSS) and histopathological examination of skin biopsy. Materials and Methods: A prospective study involving thirty cases of leprosy presenting with single skin lesion to the department of dermatology of a tertiary care hospital spread over 2 years. Examination of skin lesion and nerves was carried out, and details were recorded. Routine hematological and biochemical investigations were done. SSS from the lesion, both ear lobes, right elbow, left middle finger, and right middle toe and lesional biopsy was done. Bacteriological index and morphological index were calculated in all cases, and the diagnosis was correlated by histopathology. Results: Of the thirty cases studied, twenty were males (66.7%) and ten (33.3%) were females with male-to-female ratio of 2:1. The most common age group afflicted was 21–40 years (70%). Hypopigmented patch was the most common presentation 19 (63.3%) in our study. The most common site of patch was forearm in 9 (30%). Of the thirty cases, 20 (66.7%) were diagnosed as borderline tuberculoid, 9 (30%) as tuberculoid tuberculosis, and 1 (3.3%) as indeterminate leprosy. Ulnar nerve was the most common nerve involved (80%). Ten patients (33.3%) were positive and twenty (66.7%) were negative for acid-fast bacilli on SSS examination. Out of the thirty clinically diagnosed leprosy cases, 19 (63.3%) showed positive histopathological correlation. Conclusions: The presentation of borderline lepromatous leprosy and lepromatous leprosy as single skin lesion reinforces the fact that certain aspects of the host cell-mediated response and pathophysiology of this disease are still not fully understood. It illustrates the importance of SSS and biopsy in these cases as such cases are undertreated.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42923179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Systemic lupus erythematosus (SLE) is an autoimmune connective disorder characterized by the presence of autoantibodies. Indirect immunofluorescence is considered as the gold standard for the detection of antinuclear antibodies (ANA). False-negative ANA results have resulted in misclassification of some patients as ANA-negative SLE. There are many possible explanations for this negative ANA status of SLE patients. Current evidence in literature suggests that ANA-negative lupus is a questionable entity.
{"title":"Antinuclear antibody-negative systemic lupus erythematosus","authors":"K. Muralidharan, Raghavendra Rao","doi":"10.4103/cdr.cdr_63_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_63_21","url":null,"abstract":"Systemic lupus erythematosus (SLE) is an autoimmune connective disorder characterized by the presence of autoantibodies. Indirect immunofluorescence is considered as the gold standard for the detection of antinuclear antibodies (ANA). False-negative ANA results have resulted in misclassification of some patients as ANA-negative SLE. There are many possible explanations for this negative ANA status of SLE patients. Current evidence in literature suggests that ANA-negative lupus is a questionable entity.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46879684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Prathibha, Akanksha Prasad Cherala, Ishwara P Bhat, Suravi Mohanthy
Primary cutaneous lymphomas (PCLs) are non-Hodgkin's lymphomas present in the skin, with no evidence of extracutaneous disease at the time of diagnosis. PCL is uncommon in children, and those that do exist are mostly of the T-cell lineage. PCL of the B-cell linage is most common in the sixth decade of life and is extremely rare in childhood.
{"title":"A rare case of primary cutaneous B-Cell lymphoma in a child","authors":"J. Prathibha, Akanksha Prasad Cherala, Ishwara P Bhat, Suravi Mohanthy","doi":"10.4103/cdr.cdr_99_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_99_21","url":null,"abstract":"Primary cutaneous lymphomas (PCLs) are non-Hodgkin's lymphomas present in the skin, with no evidence of extracutaneous disease at the time of diagnosis. PCL is uncommon in children, and those that do exist are mostly of the T-cell lineage. PCL of the B-cell linage is most common in the sixth decade of life and is extremely rare in childhood.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42402683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Parmar, J. Tandel, Rutoo V. Polra, J. Patel, P. Nair
Lymphocytoma cutis (LC) is one of the pseudolymphomas. It clinically and histopathologically resembles to cutaneous lymphomas due to the accumulation of lymphocytes. LC can be solitary characterized by only one nodule or disseminated, presenting as extensive lesions. It presents with soft and doughy or firm nodules, skin color, reddish brown, or reddish purple mainly on exposed area, such as the face. It has to be differentiated from Jessner's lymphocytic infiltrate of skin by histopathological and immunohistochemical examinations. Apart from treatment, follow-up of patients is crucial, as the condition can evolve into cutaneous lymphoma. We present a case of 54-year-old male, with lesions over the face, trunk, and both extremities diagnosed with disseminated LC.
{"title":"Disseminated lymphocytoma cutis in a patient with B-cell non-hodgkin's lymphoma","authors":"D. Parmar, J. Tandel, Rutoo V. Polra, J. Patel, P. Nair","doi":"10.4103/cdr.cdr_115_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_115_21","url":null,"abstract":"Lymphocytoma cutis (LC) is one of the pseudolymphomas. It clinically and histopathologically resembles to cutaneous lymphomas due to the accumulation of lymphocytes. LC can be solitary characterized by only one nodule or disseminated, presenting as extensive lesions. It presents with soft and doughy or firm nodules, skin color, reddish brown, or reddish purple mainly on exposed area, such as the face. It has to be differentiated from Jessner's lymphocytic infiltrate of skin by histopathological and immunohistochemical examinations. Apart from treatment, follow-up of patients is crucial, as the condition can evolve into cutaneous lymphoma. We present a case of 54-year-old male, with lesions over the face, trunk, and both extremities diagnosed with disseminated LC.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48126748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anetodermas is a rare disorder of connective tissue associated with a circumscribed area of slack skin associated with focal loss of elastin. This correlates with the clinical observation of atrophy and “buttonhole” sign or herniation phenomenon. Secondary anetoderma has multiple causes, which should be looked for, out of which lepromatous leprosy is rare. It is important to identify infective conditions like leprosy not only for the individual but also epidemiological control as well. We report a case of Lepromatous leprosy presenting as anetoderma.
{"title":"Anetoderma - A hidden presentation of lepromatous leprosy","authors":"Sruthi Kareddy, C. Nikitha, P. Mamatha","doi":"10.4103/cdr.cdr_127_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_127_21","url":null,"abstract":"Anetodermas is a rare disorder of connective tissue associated with a circumscribed area of slack skin associated with focal loss of elastin. This correlates with the clinical observation of atrophy and “buttonhole” sign or herniation phenomenon. Secondary anetoderma has multiple causes, which should be looked for, out of which lepromatous leprosy is rare. It is important to identify infective conditions like leprosy not only for the individual but also epidemiological control as well. We report a case of Lepromatous leprosy presenting as anetoderma.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42382947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Shendre, Sanjay Thejaswi, Chanabasappa Mendagudli, V. Nair, Supriya Rajesh
Background: Telogen effluvium (TE) is characterized by an abrupt onset of diffuse and self-limited shedding of normal club hairs, usually seen 2–3 months after a triggering event. One of the manifestations of SARS-CoV-2 has been new-onset diffuse hair loss in patients previously infected with it, clinically compatible with TE. Thus, the present study attempts to establish hair loss as one of the sequelae of COVID-19 infection. Objective: The objective of the study was to find out the presence of hair loss in COVID-19 infection-recovered patients during the second wave of the pandemic. Materials and Methods: Google Forms was prepared with relevant questions regarding COVID-19 infection, the presence of hair loss, and aggravating and relieving factors, if any. These forms were distributed to 114 COVID-19-positive patients above 18 years of age who were diagnosed with COVID-19 infection during the second wave, and the data were collected and analyzed. Results: Out of 114 participants, majority were female. 83.8% of the participants had significant viremia symptoms. Seventy-two percent of the patients complained of hair loss. Among them, 66.7% of the patients noticed worsening hair loss after 3 weeks of COVID-19 infection, 21.7% noticed within 2–3 weeks of infection, and the remaining 11.7% noticed the same within a week of infection. 50.1% of the patients had associated stress and 12.3% had comorbidities. Conclusion: The onset of TE after COVID-19 further impairs the quality of life of patients despite recovery from the primary illness. Identifying COVID-19 infection as a potential cause of hair loss will help in educating the patients about the transient nature of the condition.
{"title":"Acute telogen effluvium: A post-COVID-19 sequela","authors":"M. Shendre, Sanjay Thejaswi, Chanabasappa Mendagudli, V. Nair, Supriya Rajesh","doi":"10.4103/cdr.cdr_104_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_104_22","url":null,"abstract":"Background: Telogen effluvium (TE) is characterized by an abrupt onset of diffuse and self-limited shedding of normal club hairs, usually seen 2–3 months after a triggering event. One of the manifestations of SARS-CoV-2 has been new-onset diffuse hair loss in patients previously infected with it, clinically compatible with TE. Thus, the present study attempts to establish hair loss as one of the sequelae of COVID-19 infection. Objective: The objective of the study was to find out the presence of hair loss in COVID-19 infection-recovered patients during the second wave of the pandemic. Materials and Methods: Google Forms was prepared with relevant questions regarding COVID-19 infection, the presence of hair loss, and aggravating and relieving factors, if any. These forms were distributed to 114 COVID-19-positive patients above 18 years of age who were diagnosed with COVID-19 infection during the second wave, and the data were collected and analyzed. Results: Out of 114 participants, majority were female. 83.8% of the participants had significant viremia symptoms. Seventy-two percent of the patients complained of hair loss. Among them, 66.7% of the patients noticed worsening hair loss after 3 weeks of COVID-19 infection, 21.7% noticed within 2–3 weeks of infection, and the remaining 11.7% noticed the same within a week of infection. 50.1% of the patients had associated stress and 12.3% had comorbidities. Conclusion: The onset of TE after COVID-19 further impairs the quality of life of patients despite recovery from the primary illness. Identifying COVID-19 infection as a potential cause of hair loss will help in educating the patients about the transient nature of the condition.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41574856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saikiran Gumma, Geetakiran Arakkal, Suryanarayana Sompalli, M. Lohita
Tuberculosis verrucosa cutis (TVC) is a common exogenous form of cutaneous infection in individuals with moderate-to-high degree of immunity to Mycobacterium tuberculosis. TVC constitutes a small proportion of extrapulmonary tuberculosis which manifests as well-defined warty plaques occurring mostly on hands, knees, ankles, and buttocks. We herein report a case of TVC with unilateral and multifocal involvement in a 36-year-old male which was undiagnosed for 25 years. The diagnosis was confirmed by histopathology, and the patient responded well to antituberculous treatment.
{"title":"Unilateral Multifocal tuberculosis verrucosa cutis: A diagnostic challenge","authors":"Saikiran Gumma, Geetakiran Arakkal, Suryanarayana Sompalli, M. Lohita","doi":"10.4103/cdr.cdr_85_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_85_21","url":null,"abstract":"Tuberculosis verrucosa cutis (TVC) is a common exogenous form of cutaneous infection in individuals with moderate-to-high degree of immunity to Mycobacterium tuberculosis. TVC constitutes a small proportion of extrapulmonary tuberculosis which manifests as well-defined warty plaques occurring mostly on hands, knees, ankles, and buttocks. We herein report a case of TVC with unilateral and multifocal involvement in a 36-year-old male which was undiagnosed for 25 years. The diagnosis was confirmed by histopathology, and the patient responded well to antituberculous treatment.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41396510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kolluri Siva Bala Vaishnavi, Geetakiran Arakkal, M. Lohita, S. Kodali
Systemic capillary leak syndrome (SCLS) is a potentially life-threatening condition characterized by recurrent episodes of massive plasma sequestration into the interstitial space causing vascular collapse. SCLS is a rare syndrome where only a few cases are published in literature. The etiology being either idiopathic (Clarkson's disease) or secondary to underlying causes such as sepsis and drugs and diagnosis is often missed due to nonspecific presentation. We hereby present a case of pustular psoriasis on acitretin who developed SCLS after increasing the dose and eventually succumbed. Acitretin is considered the drug of choice in extensive psoriasis despite having side effect profiles. Although most of them are dose dependent and not life threatening. This is one of the rare complications where early detection of the condition, withdrawal of the drug, and appropriate management can be lifesaving.
{"title":"Acitretin-Induced systemic capillary leak syndrome","authors":"Kolluri Siva Bala Vaishnavi, Geetakiran Arakkal, M. Lohita, S. Kodali","doi":"10.4103/cdr.cdr_2_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_2_22","url":null,"abstract":"Systemic capillary leak syndrome (SCLS) is a potentially life-threatening condition characterized by recurrent episodes of massive plasma sequestration into the interstitial space causing vascular collapse. SCLS is a rare syndrome where only a few cases are published in literature. The etiology being either idiopathic (Clarkson's disease) or secondary to underlying causes such as sepsis and drugs and diagnosis is often missed due to nonspecific presentation. We hereby present a case of pustular psoriasis on acitretin who developed SCLS after increasing the dose and eventually succumbed. Acitretin is considered the drug of choice in extensive psoriasis despite having side effect profiles. Although most of them are dose dependent and not life threatening. This is one of the rare complications where early detection of the condition, withdrawal of the drug, and appropriate management can be lifesaving.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49440746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acral persistent papular mucinosis with lichenoid drug reaction due to isotretinoin on background of dyschromatosis universalis hereditaria","authors":"T. Ramprasanth, Y. Sharma, M. Deora, Aayush Gupta","doi":"10.4103/cdr.cdr_33_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_33_22","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43890393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abhishek S. Patokar, Chandrakant B. Poulkar, Nitin C Chaudhari, S. Khatu, Mahak Kukreja, G. Bhasin
Background: Nail involvement is a feature of 30%–50% of psoriasis patients. Only 5%–10% of patients have isolated nail psoriasis. Examination of the nail unit using a dermoscope is known as onychoscopy. The usefulness of onychoscopy in the early detection of nail psoriasis needs to be evaluated. Objective: The objective of this study was to describe the onychoscopic features in chronic plaque psoriasis patients. Materials and Methods: In this cross-sectional study, 100 patients with chronic plaque psoriasis were recruited. Onychoscopy was performed, and results were compared with the same age- and sex-matched controls. The various onychoscopic features were assessed using the Chi-square test (P < 0.05 was considered significant). The statistical analysis was done using the application named Epi Info™. Results: Out of 100 psoriasis patients, 39 patients showed clinically evident nail involvement on the naked eye, whereas 64 patients showed nail involvement on onychoscopic examination. The mean age of patients observed in our study was 37.5 years. Out of 64 patients, 43 were male and 21 were female. Pitting was the most common finding seen in 55 (85.93% and P = 0.0001) patients, followed by transverse groove in 18 (28.12% and P = 0.025), subungual hyperkeratosis in 16 (25% and P = 0.035), nail plate crumbling in 16 (25% and P = 0.0009), and oil drop sign in 8 (12.5% and P = 0.010) patients. Only these five parameters were statistically significant. Furthermore, other findings observed were onycholysis in 7 (10.93% and P = 0.166), leukonychia in 12 (18.75% and P = 0.614), splinter hemorrhages in 8 (12.5% and P = 0.099), pseudo-fiber sign in 4 (6.25% and P = 0.127), lunular red spots in 3 (4.68% and P = 0.242), and dilated globose vessels were seen in 4 (6.25% and P = 0.127) patients. Conclusion: Onychoscopy is a useful noninvasive method to detect subclinical nail involvement, which may not be visible to the naked eye.
{"title":"Onychoscopic features of nail in chronic plaque psoriasis: A cross-sectional study of 100 patients","authors":"Abhishek S. Patokar, Chandrakant B. Poulkar, Nitin C Chaudhari, S. Khatu, Mahak Kukreja, G. Bhasin","doi":"10.4103/cdr.cdr_114_21","DOIUrl":"https://doi.org/10.4103/cdr.cdr_114_21","url":null,"abstract":"Background: Nail involvement is a feature of 30%–50% of psoriasis patients. Only 5%–10% of patients have isolated nail psoriasis. Examination of the nail unit using a dermoscope is known as onychoscopy. The usefulness of onychoscopy in the early detection of nail psoriasis needs to be evaluated. Objective: The objective of this study was to describe the onychoscopic features in chronic plaque psoriasis patients. Materials and Methods: In this cross-sectional study, 100 patients with chronic plaque psoriasis were recruited. Onychoscopy was performed, and results were compared with the same age- and sex-matched controls. The various onychoscopic features were assessed using the Chi-square test (P < 0.05 was considered significant). The statistical analysis was done using the application named Epi Info™. Results: Out of 100 psoriasis patients, 39 patients showed clinically evident nail involvement on the naked eye, whereas 64 patients showed nail involvement on onychoscopic examination. The mean age of patients observed in our study was 37.5 years. Out of 64 patients, 43 were male and 21 were female. Pitting was the most common finding seen in 55 (85.93% and P = 0.0001) patients, followed by transverse groove in 18 (28.12% and P = 0.025), subungual hyperkeratosis in 16 (25% and P = 0.035), nail plate crumbling in 16 (25% and P = 0.0009), and oil drop sign in 8 (12.5% and P = 0.010) patients. Only these five parameters were statistically significant. Furthermore, other findings observed were onycholysis in 7 (10.93% and P = 0.166), leukonychia in 12 (18.75% and P = 0.614), splinter hemorrhages in 8 (12.5% and P = 0.099), pseudo-fiber sign in 4 (6.25% and P = 0.127), lunular red spots in 3 (4.68% and P = 0.242), and dilated globose vessels were seen in 4 (6.25% and P = 0.127) patients. Conclusion: Onychoscopy is a useful noninvasive method to detect subclinical nail involvement, which may not be visible to the naked eye.","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41609014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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