Skin complications other than pressure ulcers following spinal cord injury.

This study identifies skin and nail complications other than pressure ulcers after spinal cord injury and correlate these complications to the level of injury. A prospective study was performed at the time of 679 annual spinal cord injury clinic visits from 1988 to 1991 at which time the skin and nails were examined for changes or other lesions. Clinical skin thickening and nail hypertrophy were the most frequent findings. Skin thickening occurred in 57.9% of cervical injuries, 31.6% of higher thoracic injuries, 23.6% of lower thoracic injuries, and 16.0% of thoracolumbar injuries, p < .0001. Skin thickening was also seen more commonly with increasing time after injury, 20.3% at 1 year and 51.2% at 5 years, p < .0001. Nail hypertrophy occurred in the lower extremities and was not correlated with the level of injury. Denervation and autonomic dysfunction may be implicated in these changes.