Clinical Analysis of Nonfungal Nail Disease Among Children and Adolescents- a Descriptive Cross-Sectional Study
Science Journal of Clinical Medicine
Volume 6, Issue 4, July 2017, Pages: 46-52
Received: May 29, 2017; Accepted: Jun. 12, 2017; Published: Jul. 26, 2017
Views 1371      Downloads 80
Sushmita Pradhan, Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
Yaling Dai, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
Lin Xiong, Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
Article Tools
Follow on us
Background: Nonfungal nail disease in children and adolescents is a limited part of general practice. There is a wide spectrum of viral, traumatic, infectious, inflammatory and congenital conditions that may affect the nail condition in children and adolescents. Therefore assessing nonfungal nail disease and its factors will help the practitioner to recognize and treat the nail disease and determine the necessity to refer a dermatologist when indicated. This study is aimed to assess the magnitude of nonfungal nail disease, to identify the clinical characteristics and factors associated with nonfungal nail disease in children and adolescents from 1 to 18 years old. Methods: The data were collected from all cases with nonfungal nail diseases with the use of descriptive cross-sectional study, under the age of 19 years old in West China Hospital, Sichuan University. Interview, nail sample for direct microscopy and culture along with clinical pictures were taken. Finally collected data was analyzed using the Software Package for Social Science (SPSS) version 21. Results: A total of 187 patients fulfilled the inclusion criteria for the study. The mean age of the cases was 5.5 years (SD±3.8), female 96 (51.3%) and male 91 (48.90%). The majority of 113 (60.40%) were at the age category <5 years of age. A large number of patients, 175 (93.6%) were residing in the urban area. Around 77 (41.20%), 44 (23.50%), 37 (19.78%) cases were identified to have a history of the common cold disease, hand-foot-mouth disease, and skin diseases, respectively. Among all cases, the magnitude of onychomadesis was 50 (26.70%). On binary logistic regression age (P value 0.001), hand-foot-mouth disease (P value 0.0001) and skin disorder (P value 0.020) were significantly associated with onychomadesis. Finally on multiple logistic regression only age and hand-foot-mouth disease were significantly associated at, (P value 0.006) and (P value 0.0001) respectively. Conclusion: This study determines that the occurrence of nonfungal nail disease decreases with the increase in the age of children. Onychomadesis was the most common nonfungal nail disease found in children and it affected both the hands. The age and hand-foot-mouth disease were statistically significant to onychomadesis. However, more powerful and precise studies are needed in future.
Nonfungal, Nail Disease, Children, Adolescents, Clinical Analysis, Descriptive Cross-Sectional Study, Onychomadesis
To cite this article
Sushmita Pradhan, Yaling Dai, Lin Xiong, Clinical Analysis of Nonfungal Nail Disease Among Children and Adolescents- a Descriptive Cross-Sectional Study, Science Journal of Clinical Medicine. Vol. 6, No. 4, 2017, pp. 46-52. doi: 10.11648/j.sjcm.20170604.11
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Chernoff K. A, Scher R. K. Nail disorders:Kids are not just little people. Clinics in Dermatology. 2016; 34:736-741.
Silverman RA. Diseases of the nails in infants and children. Adv Dermatol.1990;5:153-170.
Schachner L, Ling NS, Press S. A statistical analysis of a pediatric dermatology clinic. Pediatr Dermatol. 1983; 1:157-164.
Iglesias A, Tamayo L, Sosa-de-Martinez C, etal. Prevalence and nature of nail alterations in pediatric patients. Pediatr Dermatol. 2001; 18:107-109.
Fan WG. Clinical study of 98 cases of nail disease. China J Dermatol. 2006; 39(10):607-607. (In Chinese).
Zou XY. Clinical analysis of 23 children with nonfungal nail disease. China J Le Dr Skin Dis. 2008; 24(10):842-842. (In Chinese).
Yin RR, Wang XR ,Xian XS, Zhang CL,Wei SH. Clinical analysis of 170 children with nonfungal dystrophy of nail. J Clin Dermatol. 2012; 41(12):721-722(InChinese).
Piraccini BM and Starace M. Nail disorders in infants and children. Curr Op in Pediatr. 2014; 26:440-445.
Baran R, Dawber RPR, deBerker DARetal. Barun and Dawber’s diseases of the nails and their management. 3rded. Oxford: Blackwell Science, 2001.
deBerker DAR, Baran R, Dawber RPR. Handbook of diseases of the nails and their management. Oxford: Blackwell Science, 1995.
Peterson RR, Spurgeon R, Lakshmi KS, Rath S. Onychomadesis in a healthy child. Indian J Paediatr Dermatol. 2015; 16:264-5.
Zaias N, Escovar S. X, Zaiac M. N. Finger and toenail Onycholysis. European Academy of Dermatology and Venereology. 2015; 29:848-853.
Laure J, MD ,Sarah Z, MD and Jacob L, MD. Mao. Nail findings in hand-foot-and-mouth disease. The Pediatric Infectious Disease Journal. 2015; 34(4):449-450.
Clementz GC, Mancini AJ. Nail matrix arrest following hand-foot-mouth disease: a report of five children. Pediatr Dermatol. 2000; 17:7-8.
Long DL, Zhu SY, Li CZ, Chen CY, Du WT, Wang X. Late-onset nail changes associated with hand,foot,and mouth disease:A clinical analysis of 56 cases. Pediatr Dermatol. 2016; 33(4):424-428.
ShahKara N and Rubin Adam I. Nail Disorders as Signs of Pediatric systemic disease. Curr Probl Pediatr Adolesc Health Care. 2012; 42:201-211.
Wu E, Viegas SF. Finger sucking and Onycholysis in an infant. J Hand Surg Am. 2005; 30:620-2.
Tosti A and Piraccini BM. Nail Disorders. Hair, Nails and Mucous Membranes. Dermatology. 3rdEd. Elsevier Saunders. 2012:1129-1147.
Barth JH, Dawber RP. Diseases of the nails in children. Pediatr Dermatol. 1987; 4:275-290.
James W D, Berger TG, Elston DM. Disease of the nails. Diseases of the Skin appendages. Andrew’s Diseases of the skin: clinical dermatology. 11ed. USA. Saunders Elsevier. 2011:741-782.
Kumar MG, Ciliber to Hand Bay liss SJ. Long-term follow up of pediatric Trachyonychia. 2015; 32:198-200.
Sehgal VN. Twenty nail dystrophy trachyonychia: an overview. J Dermatol. 2007; 34:361-366.
Tosti A, Piraccini BM, Cambiaghi S, Jorizzo M. Nail lichen planus in children clinical features, response to treatment and long term follow-up. Arch Dermatol. 2001; 137:1027-1032.
Wong SS, Yip CC, Lau SK, etal. Human enterovirus 71 and hand, foot and mouth disease. Epidemiol Infect. 2010; 138:1071-1089.
Clementz GC, Mancini AJ. Nail matrix arrest following hand-foot-mouthdisease report: a report of five children. Pediatr Dermatol. 2000; 17(1):7-11.
BernierV, Labreze C, Bury F, Taleb A. Nail matrix arrest in the course of hand, foot and mouth disease. Eur J Pediatr. 2001; 160(11):649-51.
Osterback R, Vuorinen T, Linna M, Susi P, Hyypia T, Waris M. Coxsackievirus A6 and hand, foot, and mouth disease, Finland Emerg Infect Dis. 2009; 15(9):1485-8.
Redondo Grando MJ, Torres Hinojal MC, Izquierdo Lopex B. Brotedeonicoma desisposviricaen Valladolid. [Postviral Onychomadesisout breakin Valladolid]. Spanish. AnPediatr (Barc). 2009; 71(5):439-9.
Blomqvist S, Klemola P, Kaijalainen S, Paananen A, Simonen ML,Vuorinen T, etal. Co-circulation of coxsackieviruses A6 and Also in hand, foot and mouth disease outbreak in Finland. J Clin Virol. 2010; 48(1):49-54.
Davia JL, Bel PH, Ninet VZ, Bracho MA, Gonzalez-Candelas F, Salazar A, Gobernado M, Bosch IF. Onychomadesis outbreak in Valencia, Spain associated with hand, foot and mouth disease caused by enterviruses. Pediatr Dermatol. 2011; 28(1):1-5.
TANG Jian-Ping, HU Meng-Ye, WEI Zhu. Clinical features of onychomadesis following hand-foot-mouth disease in children. China J Contemp Pediatr. 2014; 16(12):1275-1276. [In Chinese].
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186