DOI: 10.36347/sjams.2018.v06i08.019

Pages: 3038-3042

Involvement of the nail is moderatelyuniversal in psoriasis and at times maybe the sole diagnosticclue. However, the histopathology of nail psoriasis has notbeen sufficientlyassessed. A confirmation of the diagnosis is required in casessuspected to have nail psoriasis in order to plan long-term therapy. To study clinical spectrum and evaluate role of histopathological changes in nail diseases using nail biopsy. Clinical and mycological features were studied in 48 patients with nailpsoriasis. Of these, 30 patients gave consent for nail biopsies to be taken and thehistopathological changes were assessed. Males were affected more commonly (70%) with a peak incidence in theage group of 21-40 years (46.7%). Averages of nails infection duration in our 30 cases were 34.03±42.5 (months). Distal subungual hyperkeratosis, onycholysis, pitting, yellowish discolouration, beau's line longitudinal striation, koilonychia, crumbling, pterygium, blackish dis, melanonychia and white patchy dis were the predominant clinical features.Histopath impression were leuconychia in 3(10%), Nail LP in 2 (6.6%), nail psoriasis in 8 (26.7%), onychomycosis in 15 (50%) and pachyonychiacongenita in 2 (6.6%). PAS stain was positive in only Onychomycosis diseases and in outer disease were negative. Histopathological examination of nails is a valuable diagnostic aid,especially inthe absence of skin lesions. Examination of the PAS-stained sectionsis necessary before making a histological diagnosis of nail psoriasis because onychomycosisand psoriasis may show similar histology.