天疱疮是一组自身免疫性粘膜皮肤大疱性疾病,其特征是由靶向上皮细胞表面抗原的自身抗体引起的棘皮松解。研究反映了一些患者的指甲表现,并提示与临床严重程度的潜在相关性。这项研究检查了天疱疮的总体患病率,并描述了指甲变化的各种表现。我们搜查了科克伦,MEDLINE,EMBASE,和LILACS从1990年到2023年6月26日,用于报告天疱疮患者不同指甲变化的研究。收集并汇总数据,以获得天疱疮患者指甲变化的患病率比例,并对天疱疮和寻常型天疱疮进行亚组分析。使用JoannaBriggs研究所清单评估了偏见的风险。在筛选的321项研究中,包括14项研究,包括1,208名患者。甲沟炎(n=185)和Beau线(n=104)是最常见的指甲变化。天疱疮患者指甲疾病的合并患病率为0.389(研究数量;[95%CI]:n=9;[0.160-0.680],研究之间具有高度异质性(I2=95.0%,P<0.001)。亚组分析显示,天疱疮的患病率最高,为0.342(n=3;[0.109-0.688]),寻常型天疱疮的患病率最高,为0.396(n=5;[0.114-0.769])。指甲变化与疾病发作和耀斑表现出不同的时间关系,前面,并发,或跟随这些事件。注意到与疾病严重程度的相关性,尽管报告了研究之间的差异。天疱疮的指甲变化,特别是寻常型天疱疮和叶状天疱疮,可能被低估了。关于与疾病严重程度的时间关联和潜在相关性的观察突出了天疱疮指甲变化的诊断和预后意义。本研究的局限性包括研究异质性和可能的偏倚。进一步研究以确定指甲变化的存在和严重程度对整个疾病过程的相关性将是有帮助的。
Pemphigus is a group of autoimmune mucocutaneous bullous disorders characterized by acantholysis resulting from autoantibodies targeting epithelial cell surface antigens. Studies reflect the presence of nail manifestations in some patients and suggest a potential correlation with clinical severity. This study examines the overall prevalence and characterizes the diverse manifestations of nail changes in pemphigus. We searched Cochrane, MEDLINE, EMBASE, and LILACS from 1990 to June 26, 2023 for studies reporting different nail changes in pemphigus patients. Data were collected and pooled to obtain proportions of the prevalence of nail changes in patients with pemphigus and subgroup analysis for pemphigus foliaceous and pemphigus vulgaris. The risk of bias was assessed with the Joanna Briggs Institute Checklist. Of 321 studies screened, 14 studies with 1,208 patients were included. Paronychia (n = 185) and Beau\'s lines (n = 104) were the most common nail changes identified. The pooled prevalence of nail disease in pemphigus patients was 0.389 (number of studies; [95% CI]: n = 9; [0.160-0.680], with high heterogeneity between studies (I2 = 95.0%, P < 0.001). Subgroup analysis revealed the highest prevalence in pemphigus foliaceous at 0.342 (n = 3; [0.109-0.688]) and pemphigus vulgaris at 0.396 (n = 5; [0.114-0.769]). Nail changes exhibited varied temporal relationships with disease onset and flares, preceding, concurrent, or following these events. Correlation with disease severity was noted, although discrepancies between studies were reported. Nail changes in pemphigus, particularly pemphigus vulgaris and pemphigus foliaceous, may be underrecognized. Observations regarding temporal associations and potential correlations with disease severity highlight the diagnostic and prognostic implications of nail changes in pemphigus. The limitations of this study include study heterogeneity and possible bias. Further research to establish the correlation of the presence and severity of nail changes on the overall disease course would be helpful.