Nail abnormalities associated with various dermatoses in a tertiary care center in North India: A cross-sectional study

Background: Nail is an important structure both functionally and cosmetically. Nail examination is an integral part of a complete dermatological examination and can provide a clue in the diagnosis and severity of skin diseases. Purpose: The aim of the study is to study the pattern of nail changes in various dermatoses. Methods: The present study was a cross-sectional study conducted among 550 patients attending dermatology outpatient department in a tertiary care center in North India. A prestructured pro forma captured detailed demographic profile, clinical examination related to various dermatoses, and associated nail changes. KOH examination, fungal or bacterial culture, nail biopsy, and radiographic studies were done when indicated. The data analysis was done using the Statistical Package for Social Sciences (SPSS) version 21.0. Results: Majority of patients had onychomycosis (48%) followed by psoriasis (29%), paronychia (5%), vitiligo (4.7%), lichen planus (4%), and alopecia areata (2.3%). Twenty-nail dystrophy was noticed in three patients. The most common type of onychomycosis was distal lateral subungual onychomycosis (89%). Pits were seen in all psoriatic patients. Longitudinal ridges were the most frequent nail change in lichen planus (83%) and vitiligo (80%). Conclusion: Nails, in spite of being easily accessible for examination, are often overlooked. A variety of nail changes occur in various dermatological conditions and may be helpful in achieving a diagnosis.