1/2. Acute paronychia heralding the exacerbation of pemphigus vulgaris.Acute paronychia, the suppurative inflammation involving the paronychium of the nails, is usually caused by bacterial or fungal infection and has been rarely reported as a presentation of pemphigus vulgaris (PV). We report a woman with PV who presented with suppurative paronychia of multiple fingernails and toenails, which preceded the exacerbation of other mucocutaneous lesions. A biopsy specimen of the paronychium revealed suprabasal vesicles due to acantholysis. Systemic corticosteroids and adjuvant immunosuppressants were effective in treating mucocutaneous lesions as well as nail disease. We conclude that in patients with PV, acute paronychia could be a manifestation of the disease per se, rather than an infectious process. Only the precise diagnosis with adequate immunosuppressive treatment can lead to good control of disease activity.- - - - - - - - - - ranking = 1keywords = vulgaris (Clic here for more details about this article) |
2/2. paronychia--a manifestation of pemphigus vulgaris.Involvement of the nail unit in pemphigus vulgaris is thought to be uncommon. However, trachyonychia, nail atrophy, onychomadesis, onycholysis, nail bed erosion, onychoschizia, subungual haemorrhage, nail pitting, nail plate discoloration, cross-ridging of nail plate, Beau's line and paronychia have been reported. These manifestations may be due either to secondary extension of the bulla adjacent to the nail or primary involvement of the nail bed, nail matrix and nail fold. We report four patients with pemphigus vulgaris who developed paronychia with a corresponding exacerbation of their cutaneous lesions. Nail fold biopsy and direct immunofluorescence revealed features of permphigus vulgaris. Treatment with immunosuppressive agents showed simultaneous improvement of both cutaneous and nail lesions.- - - - - - - - - - ranking = 1.4keywords = vulgaris (Clic here for more details about this article) |