ONYCHOMYCOSIS AMONG EGYPTIAN PSORIATICS

Abstract

Psoriasis is a conunon genetically determined, inflammatory and proliferative disease of the skin, the most characteristic lesions consisting of chronic sharply demarcated dull-red, scaly plaques, particularly on the extensor prominences and in the scalp. The disease is enormously variable in duration and extent and morphological variants are conunon.

Psoriasis also affects the nails, the inter-triginous areas, the retro-auricular areas, thepenis, palms, soles and oral mucosa.

Nail involvement occurs with all types of psoriasis of the skin and is frequently present with psoriatic arthropathy. Nail changes are present in 25 - 50% of all cases. There is no sex predilection, but patients over 40 years are affected twice as often as those under 20 years. Psoriasis may be restricted to the nails, but minimal changes should always be looked for in the scalp or on the genitalia. Severe nail involvement does not imply severe psoriasis of the skin and the type of nail change is not associated with any particular distribution of the skin lesions.

In order of reducing frequency, nail signs of psoriasis include; pitting, onycholysis, subungual hyperkeratosis, nail plate discolouration, uneven nail surface, splinter haemorrhages, acute and chronic paronychia and transverse midline depressions. These clinical manifestations might alter the susceptibility to fungal infection and could predispose to onychomycosis. •