Prevalence of Onychomycosis in Patients with Autoimmune Diseases
Papapit Tuchinda MD*, Waranya Boonchai MMedSc, MD*, Puangpetch Prukpaisarn MD*, Chanai Maungprasat BEd*, Puan Suthipinittharm MD*
Affiliation : * Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University
Background : Onychomycosis is the most common nail disorder in adults. Many studies reported a higher
prevalence of onychomycosis among particular patients, such as those with diabetes, poor peripheral
circulation or immunosuppression. However, studies of the prevalence of onychomycosis in autoimmune
patients who carry many of these predisposing factors have been limited.
Objective : Study the prevalence of onychomycosis in autoimmune compared to non-autoimmune female
patients
Materials and Methods : A cross-sectional study of the prevalence of onychomycosis in autoimmune patients
and non-autoimmune female patients visiting a dermatology clinic over a period of 18 months. One hundred
and sixty-five female autoimmune patients were enrolled.
Results : The prevalence of onychomycosis in autoimmune patients was 10.2% (95%CI 6.5%, 15.9%) compared
to 6.7% (95%CI 3.8%, 11.6%), in non-autoimmune patients (p > 0.05, 2-sided). Of vesiculobullous patients,
mainly presenting with pemphigus and who were mostly on immunosuppressive medication, 24% had
onychomycosis [p = 0.013; OR 4.39 (95%CI 1.27, 14.89)].
Conclusion : Exposure to humid microenvironments was an important factor in the occurrence of
onychomycosis (p < 0.05, 2-sided). However, the number of patients with each individual disease was too
small to conclude a prevalence of onychomycosis in conjunction with these individual cutaneous autoimmune
diseases.
Keywords : Onychomycosis, Tinea unguium, Autoimmune diseases
