PARONYCHIA - A MANIFESTATION OF PEMPHIGUS-VULGARIS

Involvement of the nail unit in pemphigus vulgaris is thought to be un common. However, trachyonychia, nail atrophy, onychomadesis, onycholys is, nail bed erosion, onychoschizia, subungual haemorrhage, nail pitti ng, nail plate discoloration, cross-ridging of nail plate, Beau's line and paronychia have been reported.(1-9) These manifestations may be d ue either to secondary extension of the bulla adjacent to the nail or primary involvement of the nail bed, nail matrix and nail fold.(4) We report four patients with pemphigus vulgaris who developed paronychia with a corresponding exacerbation of their cutaneous lesions. Nail fol d biopsy and direct immunofluorescence revealed features of pemphigus vulgaris. Treatment with immunosuppressive agents showed simultaneous improvement of both cutaneous and nail lesions.