Nail Signs lichen planus 扁平苔藓指甲

Nail abnormalities are present in ~10% of patients with lichen planus. However, nail lichen planus is most frequently seen in the absence of skin, scalp, or mucosal involvement. In a study of 24 adults with nail lichen planus, nail changes were the sole manifestation of the disease in 75%, and the proportion may be higher in children.

Clinical findings that are diagnostic include nail thinning, atrophy, longitudinal ridging and fissuring, and dorsal pterygium (due to scarring). Several nails are usually affected. The presence of onychorrhexis and thinning indicates matrix involvement and the need for prompt treatment to avoid scarring. Dorsal pterygium results from adhesion of the proximal nail fold to the nail bed due to matrix destruction and disappearance of the nail plate.

lichenplanus

大约10％的扁平苔藓患者存在指甲异常。在一项对24名患有扁平苔藓的成年人的研究中，指甲变化是该疾病的唯一表现，占75％，儿童的比例可能更高。临床诊断包括指甲变薄，萎缩，纵向皱褶和裂隙，以及由于瘢痕形成的背侧翼状胬肉。

Reference:

  1. A Tosti, AM Peluso, PA Fanti, et al.: Nail lichen planus: clinical and pathologic study of twenty-four patients. J Am Acad Dermatol. 28:724-730；1993
  2. Antonella Tosti, Bianca Maria Piraccini. In: Jean Bolognia Julie Schaffer Lorenzo Cerroni, editors. Dermatology: 2-Volume Set 4th Edition. Elsevier; 2017. p1217
  3. Tosti A, Peluso AM, Fanti PA, et al. Nail lichen planus. Clinical and pathological study of 24 patients. J Am Acad Dermatol 1993;28:724–3
  4. Tosti A, Fanti PA, Morelli R, et al. Trachyonychia associated with alopecia areata. A clinical and pathological study. J Am Acad Dermatol 1991;25:266–70