Assessment of Nail Findings in Children with Atopic Dermatitis.

Background Cutaneous findings are well known in atopic dermatitis (AD), but nail changes are generally overlooked. Objective In the present study, the aim was to determine the clinical and disease-related capillaroscopic findings of nail findings in pediatric patients with AD. Methods A total of 100 participants aged 2-16 years, admitted to the dermatology outpatient clinic, were included in the study. Among the participants there were 50 patients diagnosed with AD according to the Hanifin-Rajka criteria and 50 healthy volunteers. The atopic dermatitis severity score (SCORAD) were calculated for all patients. A digital epiluminescence device manufactured by Grimed was used for nailfold capillaroscopy. Results The nail findings detected in the patients with AD were pitting, punctate leukonychia, trachyonychia, onycholysis and onychomadesis. Pitting of the patient group (26%) was significantly higher than the control group (6%) (p=0.007). It was found that the results of the patient group was significantly higher than those of the control group in terms of capillary density decrease (p=0.007), irregularity in capillary array (p˂0.001), increase in capillary dilatation (p˂0.001), tortuosity (p=0.04), increase in ramification (p=0.02), bush-like appearance (p=0.02) and avascular areas (p=0.002). Significant correlations were determined between pitting with trachyonychia, capillary density decrease, avascular areas and the SCORAD (p˂0.05 r=0.21, p˂0.05 r=0.25 p˂0.001 r=0.29, p˂0.05 r=0.35; respectively). Conclusion In conclusion nailfold capillaroscopic images of pediatric patients with AD were similar to scleroderma spectrum disorder. Hence, it was considered that it would be beneficial to support the detailed clinical examination of the patients with a capillaroscopic examination.