E-ISSN 2651-5164 / Print-ISSN 2717-6398
Histopathological investigation of onychomycosis frequency in psoriatic nails using periodic acid-Schiff staining [TURKDERM]
TURKDERM. 2020; 54(3): 103-107 | DOI: 10.4274/turkderm.galenos.2020.23090

Histopathological investigation of onychomycosis frequency in psoriatic nails using periodic acid-Schiff staining

Mavişe Yüksel1, Ali Balevi1, Mustafa Özdemir1, İlknur Türkmen2, Alkım Ünal Çakıter1, Esra Saraç1, Mehmet Ünal3, Elif Çalış2
1İstanbul Medipol University Faculty of Medicine, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
2İstanbul Medipol University Faculty of Medicine, Department of Pathology, İstanbul, Turkey
3Selçuk University Faculty of Medicine, Department of Dermatological and Venereal Diseases, Konya, Turkey

Background and Design: Psoriasis nail involvement is clinically similar to onychomycosis. Especially subungual hyperkeratosis and onycholysis are also common in both nail diseases. These two diseases may be seen separetely or together. The aim of this study was to compare the frequency of onychomycosis with control group in patients with psoriasis and to determine the factors predisposing to onychomycosis in patients with psoriasis.
Materials and Methods: The study included 43 patients with psoriasis who were admitted to İstanbul Medipol Mega University, Clinic of Dermatology between 2017 and 2018 and 43 control patients who did not have psoriasis and had nail dystrophy. Participants who received systemic corticosteroid, methotrexate, cyclosporine, and systemic antifungal treatment 4 months ago and who received topical antifungal treatment 4 weeks ago were excluded from the study. The nail samples were examined histochemically with periodic acid-Schiff (PAS) stain.
Results: Onychomycosis was detected in 11 patients with psoriasis (25.6%) (hand and/or foot), while in 17 patients (39.5%) in control group. There was no statistically significant difference between two groups (p=0.170). In control group, toe nail onychomycosis was significantly higher than in the psoriatic group (p=0.024). It was noteworthy that onychomycosis was statistically significant in the group with high educational level and low Psoriasis Area Severity Index (p<0.05 and p=0.021, respectively).
Conclusion: In this study, we determined that nail psoriasis is not a risk factor for onychomycosis by histopathological examination of fungal samples with PAS staining.

Keywords: Onychomycosis, psoriasis, periodic acid-Schiff

Psoriasisli tırnakta onikomikoz sıklığının periodik asit-Schiff boyama ile histopatolojik olarak araştırılması

Mavişe Yüksel1, Ali Balevi1, Mustafa Özdemir1, İlknur Türkmen2, Alkım Ünal Çakıter1, Esra Saraç1, Mehmet Ünal3, Elif Çalış2
1İstanbul Medipol University Faculty of Medicine, Department of Dermatological and Venereal Diseases, İstanbul, Turkey
2İstanbul Medipol University Faculty of Medicine, Department of Pathology, İstanbul, Turkey
3Selçuk University Faculty of Medicine, Department of Dermatological and Venereal Diseases, Konya, Turkey

Amaç: Psoriazis tırnak tutulumu klinik olarak onikomikoza benzer. Özellikle; subungual hiperkeratoz ve onikoliz iki tırnak hastalığında da yaygın olarak görülür. Bu iki hastalık ayrı ayrı olabileceği gibi birlikte de olabilir. Bu çalışmanın amacı, psoriazisli hastalarda onikomikoz sıklığının kontrol grubuyla karşılaştırılması ve psoriazisli hastalarda onikomikoza predispozan faktörlerin tespitinin sağlanmasıdır. Gereç ve Yöntem: Çalışmaya 2017-2018 yılları arasında İstanbul Medipol Mega Üniversitesi, Dermatoloji Kliniği’ne başvuran 43 psoriazisli hasta ve 43 psoriazisi olmayan ve tırnak distrofisi olan kontrol grubu alındı. Dört ay önce sistemik kortikostreoid, metotreksat, siklosporin ve sistemik antifungal tedavi almış, 4 hafta önce topikal antifungal tedavi almış katılımcılar çalışmadan çıkartıldı. Alınan tırnak örnekleri periyodik asit-Schiff (PAS) boyası ile histokimyasal olarak incelendi.
Bulgular: Psoriazisi olan 11 hastada (25,6) (el ve/veya ayak) onikomikoz tespit edildirken, kontrol grubunda 17 hastada (%39,5) onikomikoz tespit edildi. Her iki grup arasında istatistiksel anlamlı fark yoktu (p=0,170). Kontrol grubunda ayak tırnak onikomikozu psoriatic gruba göre chianlamlı dercede yüksekti (p=0,024). Psoriazis hasta grunda eğitim düzeyi yüksek olan ve Psoriazis Alan Şiddet indeksi değeri düşük olanlarda onikomikozun istatistiksel olarak anlamlı derecede fazla olması dikkat çekiciydi (sırasıyla; p<0,05; p=0,021).
Sonuç: Biz bu çalışmada, tırnak psoriazisinin onikomikoz için bir risk faktörü olmadığını, mantar örneklerinin PAS boyama ile histopatolojik olarak incelenmesi ile tespit ettik.

Anahtar Kelimeler: Onikomikoz, psoriazis, periyodik asit-Schiff

Mavişe Yüksel, Ali Balevi, Mustafa Özdemir, İlknur Türkmen, Alkım Ünal Çakıter, Esra Saraç, Mehmet Ünal, Elif Çalış. Histopathological investigation of onychomycosis frequency in psoriatic nails using periodic acid-Schiff staining. TURKDERM. 2020; 54(3): 103-107

Corresponding Author: Mavişe Yüksel, Türkiye
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