Clinical spectrum of nail disorders

Background: The nail disorders comprise approximately 10% of all dermatological conditions. The nail unit may reflect dermatological disorder by its own and may show specific changes that are markers for a wide range of systemic disorders. Aims: To study the clinical spectrums of nail disorders including congenital, developmental, infectious, neoplastic, degenerative, dermatologic and systemic diseases affecting the nail unit. Materials and Methods: 200 consecutive cases with nail disorders attending to the Dermatology. Complete dermatologic and systemic examinations were carried out. Hematological investigations, including hemoglobin, total leukocyte count, differential leukocyte count and urine examination were carried out in all patients. Results: In this study, the involvement of nail was more common among males when compared to females. Onychomycosis was the commonest finding (27%) followed by psoriatic nail change (14.5%), Onycholysis (5.5%), Pitting (4.5%), Onychogryphosis (4.5%), Trachyonychia (4.5%), Chronic Paronychia (4.5%), Clubbing (4%), Subungual Warts (3.5%), Clubbing with resorption of terminal fingers (2.5%) and Ingrowing toe nail (2%). The other uncommon nail changes included Onychomadesis (1.5%), Pincer nail (1.5%), Onycholysis & pitting (1.5%), Nail discoloration (1.5%), Anonychia (1.5%), Half-and-Half nail (1.5%) Koilonychia (1.5%), Longitudinal Melanonychia (1.5%), Nail biting (1.5%), Worn down nail (1%), Transverse grooves (1%), Racket nail with clubbing (1%), Idiopathic total leuconychia (1%) and Beaus lines (1%). Also observed as single cases (0.5%) were Dorsal pterygium, Macrolunula, Longitudinal grooves, Dariers disease, Pachyonychia congenita, Acute Paronychia and Acrodermatitis continua of Hallopeau. Conclusion: Study has revealed onychomycosis, onycholysis, chronic paronychia, ingrowing toenail etc, as the common nail disorders. These conditions were associated with subclinical trauma. Nail biopsy in these patients may clarify this issue further.