Prevalence and etiology of onychomycosis in patients with psoriasis: a single-center study

BACKGROUND: Changes in nails with psoriasis are observed in 8090% of patients. Pathological processes in the nail apparatus in patients with psoriasis are associated with both the underlying disease and the infectious nature. AIMS: To evaluate the clinical features of the affected nail plates in patients with psoriasis, the prevalence and etiology of onychomycosis in patients with psoriasis with altered nail plates. MATERIALS AND METHODS: 102 patients with psoriasis vulgaris, mild and moderate, stationary stage with altered nail plates were examined. A clinical and laboratory (microscopic and cultural) study of the affected nail plates was carried out. RESULTS: After mycological studies and physical examination of the affected nails of 102 patients, the following groups of nail diseases in patients with psoriasis were identified: psoriatic onychodystrophy (76; 74.5%) patients, onychomycosis (30; 29.4%) patients, traumatic onycholysis (4; 3,9%) patient, onychocryptosis (3; 2.9%) patients. 11 (14.5%) patients with psoriatic onychodystrophy had a complication in the form of a fungal infection. Distal-lateral subungual form of onychomycosis was detected in 17 patients (56.7%), total dystrophic form ― in 10 patients (33.3%), white superficial form ― in 2 patients (6.6%), proximal subungual form ― in 1 patient (3.3%). CONCLUSIONS: According to the results of clinical and mycological examination of the affected nails of patients with psoriasis, it was revealed that 74.5% of patients have manifestations of psoriatic onychodystrophy, 29.4% ― onychomycosis. Among patients with psoriatic onychodystrophy, 14.5% had a complication in the form of a secondary fungal infection. The main causative agents of onychomycosis are Candida spp. (63.3%). The incidence of dermatophytes (Trichophyton spp.) Was 36.7% of the total number of cases. The main clinical forms of onychomycosis in patients with psoriasis are distal-lateral (56.6%), total dystrophic (33.3%).