Nail changes in dermatological diseases: A cross-sectional study at a tertiary care hospital

Background: The nail unit is involved in many skin and systemic diseases. Although easy to examine, this part is often not given due importance. For this, a deeper understanding of the various finer details of the nail changes is required. This knowledge can serve as a valuable addition to the clinical evaluation to arrive at an accurate clinical diagnosis. Objectives: The aim of this study was to assess the prevalence and spectrum of nail changes in patients with various dermatoses. Material and Methods: This was an observational, cross-sectional study conducted in the outpatient department of a tertiary care hospital. The sample size was calculated as 158. After Institutional Ethics Committee approval, patients were recruited by convenience sampling. Clinical examination and onychoscopy were done with photographic documentation after obtaining informed written consent. Descriptive statistics were applied for outcome variables, in the form of frequency and proportions. Results: A total of 163 patients (84 females and 79 males) were included in the study. The youngest patient was 1 year old, whereas the oldest was 78 years old. Dermatological disease seen in the study were clubbed into four major groups including infective (66 patients), inflammatory (64 patients), genodermatoses (10 patients), and miscellaneous (23 patients) disorders. The nail changes were divided into nail matrix, nail plate, nail bed, and nail fold changes. Onychomycosis was found to be the most common disease. Conclusion: Nail changes can provide valuable clinical insights, aiding clinicians in accurate diagnosis. Nails may provide evidence in support of diseases that may have occurred in the recent past, even though the skin manifestations may have resolved.