Onychomycosis as a warning sign for peripheral arterial disease

Peripheral arterial disease (PAD) is associated with increased risk of cardiovascular and cerebrovascular diseases. Increasing age, smoking, hyperlipidaemia, diabetes, hypertension, and male gender have been identified as risk factors for PAD (1). The possible role of dermatological diseases in the early detection of PAD remains unknown. Onychomycosis (OM) is a common disease, accounting for up to half of all reported nail diseases, with an estimated prevalence of 10% in the general population (2-4). Previous studies found that OM was associated with increasing age, gender, diabetes, psoriasis, smoking and immune dysfunction (5-7). Meanwhile, a study of patients attending a vascular clinic reported that PAD might be an independent predictor of OM (7). Based on these results, we hypothesized that OM might represent an independent clinical sign for the early detection of PAD. A university-based cross-sectional study of elderly dermatological patients with or without microscopically confirmed OM was performed to clarify the role of OM as an independent predictor of PAD.