Nail Abnormalities in Scabies Patients: A Systematic Review

Hendra Gunawan, Risa Miliawati Nurul Hidayah, Pati Aji Achdiat, Retno Hesty Maharani, Fitri Yulianti Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Hendra Gunawan, Department o...

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Main Authors: Gunawan H, Hidayah RMN, Achdiat PA, Maharani RH, Yulianti F
Format: Article
Language:English
Published: Dove Medical Press 2025-04-01
Series:Clinical, Cosmetic and Investigational Dermatology
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Online Access:https://www.dovepress.com/nail-abnormalities-in-scabies-patients-a-systematic-review-peer-reviewed-fulltext-article-CCID
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author Gunawan H
Hidayah RMN
Achdiat PA
Maharani RH
Yulianti F
author_facet Gunawan H
Hidayah RMN
Achdiat PA
Maharani RH
Yulianti F
author_sort Gunawan H
collection DOAJ
description Hendra Gunawan, Risa Miliawati Nurul Hidayah, Pati Aji Achdiat, Retno Hesty Maharani, Fitri Yulianti Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Hendra Gunawan, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel +6281221111215, Email h.gunawan2016@unpad.ac.idBackground: Nail abnormalities can be found in patients with scabies. It is commonly misdiagnosed as onychomycosis, traumatic nail disease, or nail psoriasis. Nail changes in patients with scabies are a result of the mites burrowing activity into the stratum corneum of the epidermis, which can extend to the subungual skin of the nail. There are limited studies that have been reported regarding the incidence of nail changes in patients with scabies.Objective: To systematically review nail abnormalities in patients with scabies reported in the literature.Methods: We searched all published articles in electronic databases until August 2024 reporting patients with scabies with detailed descriptions of malformed/diseased nails using specific terms and inclusion/exclusion criteria. This systematic review presents the data as a descriptive analysis.Results: We included 32 articles reporting 33 individual patients with nail scabies. There was no significant difference in the number of scabies patients with nail abnormalities in the children (33.33%), adults (30.30%), and elderly groups (36.36%). The youngest age recorded was four months and the oldest of 92 years. Scabies were more frequent in males (60.61%). According to scabies type, 81.82% of cases of scabies with nail abnormality were crusted scabies. The most prevalent diagnosis approach was direct microscopy (84.84%), followed by histopathological examination (30.30%) and dermoscopy (12.12%). Subungual hyperkeratosis (60.60%), onychodystrophy (48.48%), discoloration (33.33%), and onycholysis (21.21%) constituted the majority of nail abnormalities. Fingernail involvement occurred in 33.33% of the patients, while combined fingernail and toenail involvement occurred in 30.30% of the patients.Conclusion: Subungual hyperkeratosis, onychodystrophy, and discoloration are the most frequent nail abnormalities found in patients with scabies. In order to provide scabies patients with adequate treatment, regular nail examinations should be performed, and further prospective studies are required to completely understand the association between risk factors and abnormalities of the nail in scabies patients.Keywords: classic scabies, crusted scabies, nail abnormalities, scabies
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publishDate 2025-04-01
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series Clinical, Cosmetic and Investigational Dermatology
spelling doaj-art-4deb2f7396dc4f0cb1d9e2ef1f8730b12025-08-20T03:13:44ZengDove Medical PressClinical, Cosmetic and Investigational Dermatology1178-70152025-04-01Volume 1810191032102494Nail Abnormalities in Scabies Patients: A Systematic ReviewGunawan HHidayah RMNAchdiat PAMaharani RHYulianti FHendra Gunawan, Risa Miliawati Nurul Hidayah, Pati Aji Achdiat, Retno Hesty Maharani, Fitri Yulianti Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Hendra Gunawan, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel +6281221111215, Email h.gunawan2016@unpad.ac.idBackground: Nail abnormalities can be found in patients with scabies. It is commonly misdiagnosed as onychomycosis, traumatic nail disease, or nail psoriasis. Nail changes in patients with scabies are a result of the mites burrowing activity into the stratum corneum of the epidermis, which can extend to the subungual skin of the nail. There are limited studies that have been reported regarding the incidence of nail changes in patients with scabies.Objective: To systematically review nail abnormalities in patients with scabies reported in the literature.Methods: We searched all published articles in electronic databases until August 2024 reporting patients with scabies with detailed descriptions of malformed/diseased nails using specific terms and inclusion/exclusion criteria. This systematic review presents the data as a descriptive analysis.Results: We included 32 articles reporting 33 individual patients with nail scabies. There was no significant difference in the number of scabies patients with nail abnormalities in the children (33.33%), adults (30.30%), and elderly groups (36.36%). The youngest age recorded was four months and the oldest of 92 years. Scabies were more frequent in males (60.61%). According to scabies type, 81.82% of cases of scabies with nail abnormality were crusted scabies. The most prevalent diagnosis approach was direct microscopy (84.84%), followed by histopathological examination (30.30%) and dermoscopy (12.12%). Subungual hyperkeratosis (60.60%), onychodystrophy (48.48%), discoloration (33.33%), and onycholysis (21.21%) constituted the majority of nail abnormalities. Fingernail involvement occurred in 33.33% of the patients, while combined fingernail and toenail involvement occurred in 30.30% of the patients.Conclusion: Subungual hyperkeratosis, onychodystrophy, and discoloration are the most frequent nail abnormalities found in patients with scabies. In order to provide scabies patients with adequate treatment, regular nail examinations should be performed, and further prospective studies are required to completely understand the association between risk factors and abnormalities of the nail in scabies patients.Keywords: classic scabies, crusted scabies, nail abnormalities, scabieshttps://www.dovepress.com/nail-abnormalities-in-scabies-patients-a-systematic-review-peer-reviewed-fulltext-article-CCIDclassic scabiescrusted scabiesnail abnormalitiesscabies
spellingShingle Gunawan H
Hidayah RMN
Achdiat PA
Maharani RH
Yulianti F
Nail Abnormalities in Scabies Patients: A Systematic Review
Clinical, Cosmetic and Investigational Dermatology
classic scabies
crusted scabies
nail abnormalities
scabies
title Nail Abnormalities in Scabies Patients: A Systematic Review
title_full Nail Abnormalities in Scabies Patients: A Systematic Review
title_fullStr Nail Abnormalities in Scabies Patients: A Systematic Review
title_full_unstemmed Nail Abnormalities in Scabies Patients: A Systematic Review
title_short Nail Abnormalities in Scabies Patients: A Systematic Review
title_sort nail abnormalities in scabies patients a systematic review
topic classic scabies
crusted scabies
nail abnormalities
scabies
url https://www.dovepress.com/nail-abnormalities-in-scabies-patients-a-systematic-review-peer-reviewed-fulltext-article-CCID
work_keys_str_mv AT gunawanh nailabnormalitiesinscabiespatientsasystematicreview
AT hidayahrmn nailabnormalitiesinscabiespatientsasystematicreview
AT achdiatpa nailabnormalitiesinscabiespatientsasystematicreview
AT maharanirh nailabnormalitiesinscabiespatientsasystematicreview
AT yuliantif nailabnormalitiesinscabiespatientsasystematicreview