Nail changes in pemphigus: a systematic review and meta‐analysis
Pemphigus is a group of autoimmune mucocutaneous bullous disorders characterized by acantholysis resulting from autoantibodies targeting epithelial cell surface antigens. Studies reflect the presence of nail manifestations in some patients and suggest a potential correlation with clinical severity....
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| Veröffentlicht in: | International journal of dermatology 2024-10, Vol.63 (10), p.1308-1317 |
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| creator | Ng, Clara X. Lau Xer Min, Nicole Choi, Ellie Ci‐En Long, Valencia Chandran, Nisha Suyien |
| description | Pemphigus is a group of autoimmune mucocutaneous bullous disorders characterized by acantholysis resulting from autoantibodies targeting epithelial cell surface antigens. Studies reflect the presence of nail manifestations in some patients and suggest a potential correlation with clinical severity. This study examines the overall prevalence and characterizes the diverse manifestations of nail changes in pemphigus. We searched Cochrane, MEDLINE, EMBASE, and LILACS from 1990 to June 26, 2023 for studies reporting different nail changes in pemphigus patients. Data were collected and pooled to obtain proportions of the prevalence of nail changes in patients with pemphigus and subgroup analysis for pemphigus foliaceous and pemphigus vulgaris. The risk of bias was assessed with the Joanna Briggs Institute Checklist. Of 321 studies screened, 14 studies with 1,208 patients were included. Paronychia (n = 185) and Beau's lines (n = 104) were the most common nail changes identified. The pooled prevalence of nail disease in pemphigus patients was 0.389 (number of studies; [95% CI]: n = 9; [0.160–0.680], with high heterogeneity between studies (I2 = 95.0%, P |
| doi_str_mv | 10.1111/ijd.17257 |
| format | Article |
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Studies reflect the presence of nail manifestations in some patients and suggest a potential correlation with clinical severity. This study examines the overall prevalence and characterizes the diverse manifestations of nail changes in pemphigus. We searched Cochrane, MEDLINE, EMBASE, and LILACS from 1990 to June 26, 2023 for studies reporting different nail changes in pemphigus patients. Data were collected and pooled to obtain proportions of the prevalence of nail changes in patients with pemphigus and subgroup analysis for pemphigus foliaceous and pemphigus vulgaris. The risk of bias was assessed with the Joanna Briggs Institute Checklist. Of 321 studies screened, 14 studies with 1,208 patients were included. Paronychia (n = 185) and Beau's lines (n = 104) were the most common nail changes identified. The pooled prevalence of nail disease in pemphigus patients was 0.389 (number of studies; [95% CI]: n = 9; [0.160–0.680], with high heterogeneity between studies (I2 = 95.0%, P < 0.001). Subgroup analysis revealed the highest prevalence in pemphigus foliaceous at 0.342 (n = 3; [0.109–0.688]) and pemphigus vulgaris at 0.396 (n = 5; [0.114–0.769]). Nail changes exhibited varied temporal relationships with disease onset and flares, preceding, concurrent, or following these events. Correlation with disease severity was noted, although discrepancies between studies were reported. Nail changes in pemphigus, particularly pemphigus vulgaris and pemphigus foliaceous, may be underrecognized. Observations regarding temporal associations and potential correlations with disease severity highlight the diagnostic and prognostic implications of nail changes in pemphigus. The limitations of this study include study heterogeneity and possible bias. Further research to establish the correlation of the presence and severity of nail changes on the overall disease course would be helpful.</description><identifier>ISSN: 0011-9059</identifier><identifier>ISSN: 1365-4632</identifier><identifier>EISSN: 1365-4632</identifier><identifier>DOI: 10.1111/ijd.17257</identifier><identifier>PMID: 38887088</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Autoantibodies ; Bias ; Cell surface ; Correlation ; Epithelial cells ; Epithelium ; Heterogeneity ; Humans ; Meta-analysis ; nail ; nail changes ; Nail Diseases - diagnosis ; Nail Diseases - epidemiology ; Nail Diseases - immunology ; Paronychia - epidemiology ; Pemphigus ; Pemphigus - complications ; Pemphigus - epidemiology ; Pemphigus - immunology ; pemphigus foliaceous ; pemphigus vulgaris ; Prevalence ; Severity of Illness Index ; Subgroups ; Surface antigens</subject><ispartof>International journal of dermatology, 2024-10, Vol.63 (10), p.1308-1317</ispartof><rights>2024 the International Society of Dermatology.</rights><rights>International Journal of Dermatology © 2024 International Society of Dermatology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2437-b0037202541aab3055a5f80905e16710153457a7c093f6fb5a064d97c4e276ea3</cites><orcidid>0000-0002-2059-3478 ; 0000-0002-5445-5698</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fijd.17257$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fijd.17257$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38887088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ng, Clara X.</creatorcontrib><creatorcontrib>Lau Xer Min, Nicole</creatorcontrib><creatorcontrib>Choi, Ellie Ci‐En</creatorcontrib><creatorcontrib>Long, Valencia</creatorcontrib><creatorcontrib>Chandran, Nisha Suyien</creatorcontrib><title>Nail changes in pemphigus: a systematic review and meta‐analysis</title><title>International journal of dermatology</title><addtitle>Int J Dermatol</addtitle><description>Pemphigus is a group of autoimmune mucocutaneous bullous disorders characterized by acantholysis resulting from autoantibodies targeting epithelial cell surface antigens. Studies reflect the presence of nail manifestations in some patients and suggest a potential correlation with clinical severity. This study examines the overall prevalence and characterizes the diverse manifestations of nail changes in pemphigus. We searched Cochrane, MEDLINE, EMBASE, and LILACS from 1990 to June 26, 2023 for studies reporting different nail changes in pemphigus patients. Data were collected and pooled to obtain proportions of the prevalence of nail changes in patients with pemphigus and subgroup analysis for pemphigus foliaceous and pemphigus vulgaris. The risk of bias was assessed with the Joanna Briggs Institute Checklist. Of 321 studies screened, 14 studies with 1,208 patients were included. Paronychia (n = 185) and Beau's lines (n = 104) were the most common nail changes identified. The pooled prevalence of nail disease in pemphigus patients was 0.389 (number of studies; [95% CI]: n = 9; [0.160–0.680], with high heterogeneity between studies (I2 = 95.0%, P < 0.001). Subgroup analysis revealed the highest prevalence in pemphigus foliaceous at 0.342 (n = 3; [0.109–0.688]) and pemphigus vulgaris at 0.396 (n = 5; [0.114–0.769]). Nail changes exhibited varied temporal relationships with disease onset and flares, preceding, concurrent, or following these events. Correlation with disease severity was noted, although discrepancies between studies were reported. Nail changes in pemphigus, particularly pemphigus vulgaris and pemphigus foliaceous, may be underrecognized. Observations regarding temporal associations and potential correlations with disease severity highlight the diagnostic and prognostic implications of nail changes in pemphigus. The limitations of this study include study heterogeneity and possible bias. Further research to establish the correlation of the presence and severity of nail changes on the overall disease course would be helpful.</description><subject>Autoantibodies</subject><subject>Bias</subject><subject>Cell surface</subject><subject>Correlation</subject><subject>Epithelial cells</subject><subject>Epithelium</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>nail</subject><subject>nail changes</subject><subject>Nail Diseases - diagnosis</subject><subject>Nail Diseases - epidemiology</subject><subject>Nail Diseases - immunology</subject><subject>Paronychia - epidemiology</subject><subject>Pemphigus</subject><subject>Pemphigus - complications</subject><subject>Pemphigus - epidemiology</subject><subject>Pemphigus - immunology</subject><subject>pemphigus foliaceous</subject><subject>pemphigus vulgaris</subject><subject>Prevalence</subject><subject>Severity of Illness Index</subject><subject>Subgroups</subject><subject>Surface antigens</subject><issn>0011-9059</issn><issn>1365-4632</issn><issn>1365-4632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10EtOwzAQBmALgWgpLLgAssQGFil2HNsJOyivogo2sLYmidO6yqPECVV2HIEzchIMKSyQmM1opE-_Rj9Ch5SMqZszs0zHVPpcbqEhZYJ7gWD-NhoSQqkXER4N0J61S3cynwa7aMDCMJQkDIfo8gFMjpMFlHNtsSnxSherhZm39hwDtp1tdAGNSXCtX41eYyhTXOgGPt7eoYS8s8buo50McqsPNnuEnm-unyZ33uzxdjq5mHmJHzDpxYQw6ROfBxQgZoRz4FlI3HuaCkkJ5SzgEmRCIpaJLOZARJBGMgm0L4UGNkInfe6qrl5abRtVGJvoPIdSV61VjEgio4Bx4ejxH7qs2tr96xSlkfAjyrlTp71K6sraWmdqVZsC6k5Ror6KVa5Y9V2ss0ebxDYudPorf5p04KwHa5Pr7v8kNb2_6iM_AarEf_M</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Ng, Clara X.</creator><creator>Lau Xer Min, Nicole</creator><creator>Choi, Ellie Ci‐En</creator><creator>Long, Valencia</creator><creator>Chandran, Nisha Suyien</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2059-3478</orcidid><orcidid>https://orcid.org/0000-0002-5445-5698</orcidid></search><sort><creationdate>202410</creationdate><title>Nail changes in pemphigus: a systematic review and meta‐analysis</title><author>Ng, Clara X. ; Lau Xer Min, Nicole ; Choi, Ellie Ci‐En ; Long, Valencia ; Chandran, Nisha Suyien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2437-b0037202541aab3055a5f80905e16710153457a7c093f6fb5a064d97c4e276ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Autoantibodies</topic><topic>Bias</topic><topic>Cell surface</topic><topic>Correlation</topic><topic>Epithelial cells</topic><topic>Epithelium</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>nail</topic><topic>nail changes</topic><topic>Nail Diseases - diagnosis</topic><topic>Nail Diseases - epidemiology</topic><topic>Nail Diseases - immunology</topic><topic>Paronychia - epidemiology</topic><topic>Pemphigus</topic><topic>Pemphigus - complications</topic><topic>Pemphigus - epidemiology</topic><topic>Pemphigus - immunology</topic><topic>pemphigus foliaceous</topic><topic>pemphigus vulgaris</topic><topic>Prevalence</topic><topic>Severity of Illness Index</topic><topic>Subgroups</topic><topic>Surface antigens</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ng, Clara X.</creatorcontrib><creatorcontrib>Lau Xer Min, Nicole</creatorcontrib><creatorcontrib>Choi, Ellie Ci‐En</creatorcontrib><creatorcontrib>Long, Valencia</creatorcontrib><creatorcontrib>Chandran, Nisha Suyien</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ng, Clara X.</au><au>Lau Xer Min, Nicole</au><au>Choi, Ellie Ci‐En</au><au>Long, Valencia</au><au>Chandran, Nisha Suyien</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nail changes in pemphigus: a systematic review and meta‐analysis</atitle><jtitle>International journal of dermatology</jtitle><addtitle>Int J Dermatol</addtitle><date>2024-10</date><risdate>2024</risdate><volume>63</volume><issue>10</issue><spage>1308</spage><epage>1317</epage><pages>1308-1317</pages><issn>0011-9059</issn><issn>1365-4632</issn><eissn>1365-4632</eissn><abstract>Pemphigus is a group of autoimmune mucocutaneous bullous disorders characterized by acantholysis resulting from autoantibodies targeting epithelial cell surface antigens. Studies reflect the presence of nail manifestations in some patients and suggest a potential correlation with clinical severity. This study examines the overall prevalence and characterizes the diverse manifestations of nail changes in pemphigus. We searched Cochrane, MEDLINE, EMBASE, and LILACS from 1990 to June 26, 2023 for studies reporting different nail changes in pemphigus patients. Data were collected and pooled to obtain proportions of the prevalence of nail changes in patients with pemphigus and subgroup analysis for pemphigus foliaceous and pemphigus vulgaris. The risk of bias was assessed with the Joanna Briggs Institute Checklist. Of 321 studies screened, 14 studies with 1,208 patients were included. Paronychia (n = 185) and Beau's lines (n = 104) were the most common nail changes identified. The pooled prevalence of nail disease in pemphigus patients was 0.389 (number of studies; [95% CI]: n = 9; [0.160–0.680], with high heterogeneity between studies (I2 = 95.0%, P < 0.001). Subgroup analysis revealed the highest prevalence in pemphigus foliaceous at 0.342 (n = 3; [0.109–0.688]) and pemphigus vulgaris at 0.396 (n = 5; [0.114–0.769]). Nail changes exhibited varied temporal relationships with disease onset and flares, preceding, concurrent, or following these events. Correlation with disease severity was noted, although discrepancies between studies were reported. Nail changes in pemphigus, particularly pemphigus vulgaris and pemphigus foliaceous, may be underrecognized. Observations regarding temporal associations and potential correlations with disease severity highlight the diagnostic and prognostic implications of nail changes in pemphigus. The limitations of this study include study heterogeneity and possible bias. Further research to establish the correlation of the presence and severity of nail changes on the overall disease course would be helpful.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>38887088</pmid><doi>10.1111/ijd.17257</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2059-3478</orcidid><orcidid>https://orcid.org/0000-0002-5445-5698</orcidid></addata></record> |
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| subjects | Autoantibodies Bias Cell surface Correlation Epithelial cells Epithelium Heterogeneity Humans Meta-analysis nail nail changes Nail Diseases - diagnosis Nail Diseases - epidemiology Nail Diseases - immunology Paronychia - epidemiology Pemphigus Pemphigus - complications Pemphigus - epidemiology Pemphigus - immunology pemphigus foliaceous pemphigus vulgaris Prevalence Severity of Illness Index Subgroups Surface antigens |
| title | Nail changes in pemphigus: a systematic review and meta‐analysis |
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