{"title":"Current Knowledge on Nail Involvement in Autoimmune Bullous Disorders","authors":"Laura Vollono, Matilde Iorizzo, Bertrand Richert","doi":"10.1159/000538553","DOIUrl":null,"url":null,"abstract":"Background: There are few studies, mainly case reports, on the involvement of the nail unit in autoimmune bullous disorders. Summary: Nail involvement in autoimmune bullous disorders is a significant clinical phenomenon, marked by a range of manifestations, most often not presenting with blisters like on the skin but rather with alterations of the nail unit such as paronychia, onychomadesis, or onycholysis. This involvement is particularly notable due to the unique immunological features of the nail unit, including the expression of various antigens and the presence of Langerhans cells. Conditions like pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa acquisita, linear IgA disease, and bullous systemic lupus erythematosus can lead to nail abnormalities. The prevalence of nail manifestations varies according to the disorder, and diagnosis often relies on histopathological and immunofluorescence testing. Nail involvement correlates with disease severity and duration, sometimes serving as a herald sign. Further research is needed to guide therapeutic approaches for nail involvement in autoimmune bullous diseases. Key Messages: Nail involvement in autoimmune bullous nail disorders may be confusing as there are almost never bullae. One should keep the diagnosis in mind when facing an atypical paronychia.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Skin Appendage Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000538553","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: There are few studies, mainly case reports, on the involvement of the nail unit in autoimmune bullous disorders. Summary: Nail involvement in autoimmune bullous disorders is a significant clinical phenomenon, marked by a range of manifestations, most often not presenting with blisters like on the skin but rather with alterations of the nail unit such as paronychia, onychomadesis, or onycholysis. This involvement is particularly notable due to the unique immunological features of the nail unit, including the expression of various antigens and the presence of Langerhans cells. Conditions like pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa acquisita, linear IgA disease, and bullous systemic lupus erythematosus can lead to nail abnormalities. The prevalence of nail manifestations varies according to the disorder, and diagnosis often relies on histopathological and immunofluorescence testing. Nail involvement correlates with disease severity and duration, sometimes serving as a herald sign. Further research is needed to guide therapeutic approaches for nail involvement in autoimmune bullous diseases. Key Messages: Nail involvement in autoimmune bullous nail disorders may be confusing as there are almost never bullae. One should keep the diagnosis in mind when facing an atypical paronychia.
背景:有关自身免疫性大疱性皮肤病指甲受累的研究很少,主要是病例报告。摘要:自身免疫性大疱性皮肤病的指甲受累是一种重要的临床现象,表现多种多样,最常见的不是皮肤上的水疱,而是甲单位的改变,如甲沟炎、甲沟炎或甲沟炎。由于指甲具有独特的免疫学特征,包括各种抗原的表达和朗格汉斯细胞的存在,这种受累尤其明显。寻常天疱疮、大疱性类天疱疮、获得性大疱性表皮松解症、线性 IgA 病和大疱性系统性红斑狼疮等疾病都可能导致指甲异常。指甲表现的发病率因疾病而异,诊断通常依赖于组织病理学和免疫荧光检测。指甲受累与疾病的严重程度和持续时间有关,有时是一种预兆。需要进一步开展研究,为自身免疫性牛皮癣指甲受累的治疗方法提供指导。关键信息:自身免疫性大疱性甲病的指甲受累可能令人困惑,因为几乎从未出现过大疱。在面对非典型甲旁癣时,应牢记诊断。