Clinical Analysis of Nonfungal Nail Disease Among Children and Adolescents- a Descriptive Cross-Sectional Study

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.