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

Histopathological investigation of onychomycosis frequency in psoriatic nails using periodic acid-Schiff staining [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 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

Mavi�e Y�ksel¹, Ali Balevi¹, Mustafa �zdemir¹, �lknur T�rkmen², Alk�m �nal �ak�ter¹, Esra Sara�¹, Mehmet �nal³, Elif �al��²
¹�stanbul Medipol University Faculty of Medicine, Department of Dermatological and Venereal Diseases, �stanbul, Turkey
²�stanbul Medipol University Faculty of Medicine, Department of Pathology, �stanbul, Turkey
³Sel�uk 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 �stanbul 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 t�rnakta onikomikoz s�kl��n�n periodik asit-Schiff boyama ile histopatolojik olarak ara�t�r�lmas�

Ama�: Psoriazis t�rnak tutulumu klinik olarak onikomikoza benzer. �zellikle; subungual hiperkeratoz ve onikoliz iki t�rnak hastal��nda da yayg�n olarak g�r�l�r. Bu iki hastal�k ayr� ayr� olabilece�i gibi birlikte de olabilir. Bu �al��man�n amac�, psoriazisli hastalarda onikomikoz s�kl��n�n kontrol grubuyla kar��la�t�r�lmas� ve psoriazisli hastalarda onikomikoza predispozan fakt�rlerin tespitinin sa�lanmas�d�r. Gere� ve Y�ntem: �al��maya 2017-2018 y�llar� aras�nda �stanbul Medipol Mega �niversitesi, Dermatoloji Klini�i�ne ba�vuran 43 psoriazisli hasta ve 43 psoriazisi olmayan ve t�rnak distrofisi olan kontrol grubu al�nd�. D�rt ay �nce sistemik kortikostreoid, metotreksat, siklosporin ve sistemik antifungal tedavi alm��, 4 hafta �nce topikal antifungal tedavi alm�� kat�l�mc�lar �al��madan ��kart�ld�. Al�nan t�rnak �rnekleri periyodik asit-Schiff (PAS) boyas� 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 aras�nda istatistiksel anlaml� fark yoktu (p=0,170). Kontrol grubunda ayak t�rnak onikomikozu psoriatic gruba g�re chianlaml� dercede y�ksekti (p=0,024). Psoriazis hasta grunda e�itim d�zeyi y�ksek olan ve Psoriazis Alan �iddet indeksi de�eri d��k olanlarda onikomikozun istatistiksel olarak anlaml� derecede fazla olmas� dikkat �ekiciydi (s�ras�yla; p<0,05; p=0,021).
Sonu�: Biz bu �al��mada, t�rnak psoriazisinin onikomikoz i�in bir risk fakt�r� olmad��n�, mantar �rneklerinin PAS boyama ile histopatolojik olarak incelenmesi ile tespit ettik.

Anahtar Kelimeler: Onikomikoz, psoriazis, periyodik asit-Schiff

Mavi�e Y�ksel, Ali Balevi, Mustafa �zdemir, �lknur T�rkmen, Alk�m �nal �ak�ter, Esra Sara�, Mehmet �nal, Elif �al��. Histopathological investigation of onychomycosis frequency in psoriatic nails using periodic acid-Schiff staining. Turkderm-Turk Arch Dermatol Venereol. 2020; 54(3): 103-107

Corresponding Author: Mavi�e Y�ksel, T�rkiye

TOOLS