Background and Objectives: In patients with Ps, nail changes morphologically resemble ONM. In these cases, diagnostic procedures are essential to exclude the presence of concomitant fungal infection. Both Ps and ONM are common diseases in the general population. It is possible that in some patients the two diseases co-exist.
Study Design: Clinical trial study
Patients and methods: All patients were subjected to:
Detailed history taking. Initial screening. PASI score &NAPSI scores evaluation
Examination of nail material in patients and control groups by:
• Microscopic examination (KOH)
• Culture on Sabouraud agar
• Detection of Fungal DNA by PCR
Patients will receive MTX once a week. The total course will be 12 weeks. After the course of the treatment, another nail samples will be collected for KOH, culture and PCR assay.
Limitations: Small number of patients.
Results: The frequency of ONM in patients with nail Ps was high, PCR positive results 75%, this figure is slightly higher than that reported in many other studies. Psoriatic nails ONM were equal in both males and females as (50%vs 50%). The frequency of ONM in psoriatic nails after MTX therapy using PCR was also high as patients with PCR positive results after treatment 67%.
Conclusion: The need for obligatory mycological testing of all nail Ps patients before and after therapy as large number of patients with nail Ps were diagnosed to have ONM. PCR was more sensitive and specific in fungus detection.
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