Nail Disorders in Children With Down Syndrome: A Multicenter Study

Abstract

Background and Objectives Although skin diseases in Down syndrome (DS) have been investigated, nail disorders remain understudied. This study aims to evaluate the prevalence and clinical characteristics of nail disorders in children with DS.Methods This is a multicenter, case-control study in which 221 children with DS and 160 healthy children were recruited from 9 tertiary dermatology centers. A detailed nail and skin examination was performed by an experienced dermatologist in each center. Nail disorders were recorded.Results Of the 221 children with DS, 57% (126/221) had at least one nail disorder. The prevalence of nail disorders in the DS group was significantly higher than in the control group (p <= 0.001). Brittle nail was the most common nail disorder (19.0%, 42/221) in children with DS, followed by Beau's lines and onychomadesis (16.3%, 36/221), longitudinal ridging (12.7%, 28/221), and self-induced nail disorders (onychophagia, habitual tic deformity, and onychotillomania) (10.0%, 22/221). The risk of any nail disorder was 3 times higher, brittle nails 4.3 times, Beau's lines and onychomadesis 5.6 times, self-induced nail disorders 1.6 times, and longitudinal ridging 3.4 times higher in DS compared to the control group (p < 0.05).Conclusions Nail disorders, including brittle nails, Beau's lines, and onychomadesis, self-induced nail disorders, and longitudinal ridging, are common in DS. The identification of nail disorders in DS may aid in recognizing underlying systemic or psychiatric conditions, thereby supporting more comprehensive care for children with DS.