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Pemphigus is a group of autoimmune mucocutaneous bullous disorders characterized by acantholysis resulting from autoantibodies targeting epithelial cell surface antigens. Studies reflect the presence of nail manifestations in some patients and suggest a potential correlation with clinical severity. This study examines the overall prevalence and characterizes the diverse manifestations of nail changes in pemphigus. We searched Cochrane, MEDLINE, EMBASE, and LILACS from 1990 to June 26, 2023 for studies reporting different nail changes in pemphigus patients. Data were collected and pooled to obtain proportions of the prevalence of nail changes in patients with pemphigus and subgroup analysis for pemphigus foliaceous and pemphigus vulgaris. The risk of bias was assessed with the Joanna Briggs Institute Checklist. Of 321 studies screened, 14 studies with 1,208 patients were included. Paronychia (n = 185) and Beau's lines (n = 104) were the most common nail changes identified. The pooled prevalence of nail disease in pemphigus patients was 0.389 (number of studies; [95% CI]: n = 9; [0.160–0.680], with high heterogeneity between studies (I2 = 95.0%, P < 0.001). Subgroup analysis revealed the highest prevalence in pemphigus foliaceous at 0.342 (n = 3; [0.109–0.688]) and pemphigus vulgaris at 0.396 (n = 5; [0.114–0.769]). Nail changes exhibited varied temporal relationships with disease onset and flares, preceding, concurrent, or following these events. Correlation with disease severity was noted, although discrepancies between studies were reported. Nail changes in pemphigus, particularly pemphigus vulgaris and pemphigus foliaceous, may be underrecognized. Observations regarding temporal associations and potential correlations with disease severity highlight the diagnostic and prognostic implications of nail changes in pemphigus. The limitations of this study include study heterogeneity and possible bias. Further research to establish the correlation of the presence and severity of nail changes on the overall disease course would be helpful. [ABSTRACT FROM AUTHOR]

Detection of Merkel cell polyoma virus and beta human papillomavirus in multiple eccrine poromas in a patient with acute leukemia treated with stem cell transplant. He underwent a shave biopsy of two growths over the left abdomen and right heel in 2016 and two further biopsies for a right back and right abdominal lump in 2017. Other authors have suggested a possible role of viruses in poroma tumorigenesis.1,2 Human papillomavirus (HPV) DNA and Merkel cell polyomavirus were detected in a patient with eccrine poromatosis after allogenic stem cell transplant for acute myeloid leukemia,2 and HPV DNA was detected in another patient with eccrine poromatosis after allogenic stem cell transplant for mantle cell lymphoma.1 However, the presence of viral DNA in these lesions does not itself prove a direct causal role in the formation of eccrine poromas. [Extracted from the article]

Social media platforms such as Twitter, Facebook, and Instagram serve as useful educational tools for dermatological trainees and patients. In this piece, we discuss how dermatologists can embrace social media to improve self-learning, outreach, and patient care. Dear Editor, Social media encompasses various online platforms that facilitate information delivery and exchange through audio, image, text, and videographic means. [Extracted from the article]