![]() ![]() The main finding were perivascular round cell (70,8%), mast cells and fibroblasts (45,8%) infiltrations, increased amounts of connective tissue(75%), signs of microangiopathy (87-5%), splitting of the L-basallamina (66,7%), perivascular oedema (41,7%), deposits of complement C3(66%),IgG(62%), or both in the vessel wall and in the perivascular region, perivascular deposits of amorphic material (25%). This finding was consistent with other studies Axel F G von Bierbrauer performed nail fold biopsies of 24 patients with scleroderma. All patients had Raynaud's phenomen and digital scars. The other changes observed were longitudinal ridging, ragged cuticle, Increase of longitudinal curvature, increase in transverse curvature and beaking of the nail, marcrolunula, pseudoclubbing. In scleroderma patients, Nail Fold Telangiectasia was the abnormality most frequently seen. These results were similar to previous studies ( Table 1). The aspects most frequently seen were nail fold telangiectasia and longitudinal ridging. The proximal nailfold was found as the most site affected. Nail unit changes were present in 27 patients (69, 2%). Four of them had ragged, hyperkeratosic cuticles ( Figure 7:), 2 had nail fold telagiectasia and 3had longitudinal ridging. All the patients with nail changes in dermatomyositis group (6 patients) had nail fold erythema. Seven patients with SLE showed nail changes, proximal nail-fold erythema was noted in 4 patients, Longitudinal ridging in 4 patients, bluish- black discoloration of the nail plate in one patient ( Figure 4:), onycholysis in 2patients, subungual hyperkeratosis in 2patients ( Figure 5:) splinter haemorrhages in 3 patients ( Figure 6:) and red lunula in one patient. Ten patients had fingertip scars and two had digital necrosis. The abnormalities observed were: nail fold telangiectasia (9patients), ragged cuticles (6 patients), Longitidunal ridging (4 patients) ( Figure 1:), Increase of longitudinal curvature, and beaking of the nail (4patients) ( Figure 2:), increase in transverse curvature(4 patients) ( Figure 3:), longitudinal melanonychia (2patients) Ventral pterygium (2patients), pseudoclubbing(1patient), macrolunula (1patient), subungual keratosis in one patient. Out of 16 patients with scleroderma, 14 had nail changes. Nail unit changes were present in 27 patients (69%). The mean duration of the disease was 6 years. Thirty nine patients were enrolled in the study (33 females, 6 males) including: 16 systemic sclerosis, 14 lupus erythematosus (SLE), 8 dermatomyositis, one primary Sjorgen′s syndrome. The proximal nailfold was found to be most sites affected. The abnormalities observed were Longitidunal ridging in 11 patients, Peri ungueal erythema in 10 patients, Peri-ungual telangiectasia in 11 patients, Ragged cuticle in 10 patients fingertips scars in 9 patients, Increase of longitudinal curvature and beaking of the nail in 4 patients, Increase in transverse curvature in 4 patients, dyschromia of the proximal nail fold in 3 patients, Subungual hyperkeratosis in 3 patients, onycholysis in 2 patients, splinter haemorrhages in 3 patients, nail plate pigmentation in 2 patients, pseudoclubbing in 1 patient, macrolunula in 1 patients, Red lunulae in one patient, bluish- black discoloration of the nail plate in one patient. Thirty nine patients were enrolled including: 16 systemic sclerosis, 14 lupus erythematosus (SLE), 8 dermatomyositis (DM), 1 primary Sjorgen's syndrome. Nail features were noted and classified and photos taken. A clinical examination of the fingernails was done by the same dermatologist. We carried a prospective study between March 2012 and March2013 in our department. The objective is to identify nail unit changes associated with connective tissue diseases (CTD) and evaluate their frequency.
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