Nail changes and disorders in elderly Egyptians

Background: The nail unit is an important part of cosmetic appearance of an individual. Older people are at an increased risk of nail alterations, including normal age-related changes and disorders that more commonly affect this specific population.

Objectives: To identify and evaluate the age-related nail changes and disorders in Egyptian elderly people both clinically and histopathologically.

Patients/methods: A total of 400 adult subjects, not complaining from any dermatological disease, were included in the present study; half of them were elderly of 60 years and above (elderly group). Meanwhile, the other half served as a control group with younger ages. Full history taking, general and local examinations as well as nail biopsies were performed from selected cases with age-related nail changes and disorders.

Results: Nail changes were significantly (P < 0.05) more common in old age group (88%) compared to control subjects (39%). The commonest age-related nail changes noticed were pale, dull, opaque, and lusterless nails (73%); brittle nails (67.5%); decreased lunula visibility (49%); and onychorrhexis (45.5%). They showed highly significant increase (P < 0.001) when compared with control group.

Conclusions: The prevalence of nail changes and disorders has increased among elderly patients although they are frequently overlooked by health care providers. Dermatologist should be aware about various nail changes related to aging and those associated with other dermatoses or systemic diseases. Histopathologic picture can enhance the accuracy of clinical diagnosis of various nail changes and disorders.