Nail Involvement in Autoimmune Bullous Disorders - 11/08/11

Doi : 10.1016/j.det.2011.03.006

Antonella Tosti, MD ^a,^⁎ , Marisa André, MD ^b, Dédée F. Murrell, MA, BMBCh, FAAD, MD, FACD ^c
^a Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW, 10th Avenue, RMSB, Room 2023-A, Miami, FL 33136, USA
^b Clínica Universitária de Dermatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Avenue, Prof. Egas Moniz, 1649-035 Lisbon, Portugal
^c Department of Dermatology, St George Hospital, University of New South Wales, Gray Street, Kogarah, Sydney, NSW 2217, Australia

Corresponding author.

Résumé

Autoimmune bullous disorders frequently cause nail abnormalities, particularly paronychia and onychomadesis. In pemphigus vulgaris (PV) nail abnormalities can even precede skin findings. Nail lesions often relapse just before generalized disease exacerbation or recurrence. Severe nail changes are often associated with extensive and severe disease. Fingernails are more commonly affected. A report in the literature associates hemorrhagic nail abnormalities with poor prognosis in patients with PV. Nail scarring and pterygium are a rare complication of bullous pemphigoid. Nail loss has been occasionally reported in epidermolysis bullosa acquisita.

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Keywords : Pemphigus vulgaris, Paronychia, Onychomadesis, Onycholysis, Bullous pemphigoid, Pterygium