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N. El Moussaoui, H. Bourra, A. Abdou, S. Zarkik, K. Senouci and B. Hassam
Accepted Abstracts: J Clin Exp Dermatol Res
Introduction:The lesions of pemphigus at the periungual skin has been widely described in the literature, but the alteration of the nail is a rare phenomenon, which has been rarely reported. The aim of our study is to describe the main manifestations of nail in a group of patients with pemphigus. Material and Methods: The descriptive study was conducted at the Department of Dermatology over a period from January 2009 to September 2012. All patients with pemphigus nail affect were examined by the same dermatologist. All nail and periungual abnormalities were noted in a specially record card created for this work. Mycotic affect was immediately removed after mycological sampling, done systematically for all patients. Results: We identified 32 patients out of 53. The mean age was 50 years (18M, 14F). The most common lesions were: a paronychia, a onychomadesis, Beau?s lines or onycholysis. Involvement toenails were more frequent than fingers. In most cases the nail changes occurred simultaneously with mucocutaneous lesions, and have evolved with corticosteroids, t nails become normals, without sequels or deformation. Discussion: This study is the first to describe nail lesions during pemphigus affection. It has also been demonstrated on biopsies of the nail bed wich located antibody deposits interkeratinocytes. All components can be affected, and aspects encountered are very polymorphous: onychomadesis, onycholysis, paronychia, nail dystrophy, Beau?s lines, haemorrhage subungual, hemorrhagic paronychia, pyogenic pseudogranulomas or discoloration of nail?s plate. These changes can be explained by the fragility of the matrix, the presence of bubbles on underungueal responsible for the formation of a dystrophic nail, and its detachment from the nail?s bed. Biopsy of the nail?s bed, matrix, or fold confirme nail?s affect. However, it is not necessary if the diagnosis is already highlighted in the skin biopsy. Conclusion: The association nail manifestations-pemphigus is frequent and polymorphic. They must be sought routinely in all the patients, because they can be a criterion for severity or recurrence of pemphigus treated.
She is a young, ambitious, and serious resident at Dermatology Department at Ibn Sina University Hospital, Rabat, Morocco. She takes an active part in various national and international congresses. She is willing to perfect her continuous medical training.