皮肤镜检查在银屑病及扁平苔藓甲损诊断中的作用

Yara A. Kamel, Moshira Ali, Hoda El-Sebaei
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摘要

指甲疾病占所有皮肤病的约10%。由于仅凭临床手段诊断并不总是可能的,有时可能需要额外的诊断程序。指甲皮肤镜检查(甲镜检查)在诊断各种指甲疾病方面显示出令人鼓舞的结果。目的探讨银屑病和扁平苔藓患者的皮肤镜检查表现。患者与方法选择80例临床表现明显的银屑病伴甲扁平苔藓患者作为研究对象。将患者分为两组:1组40例甲牛皮癣患者,2组40例甲扁平苔藓患者。所有患者均接受临床检查和皮肤镜检查,以确定牛皮癣和指甲扁平苔藓的标准。结果在银屑病患者中,麻点是临床和皮肤镜下观察到的最常见的症状。刺状出血、麻点、白甲、纵向隆起、油滴征、骨膜溶解在皮镜下表现较好,支气管毛细血管扩张仅在皮镜下可见。在扁平苔藓患者中,纵向隆起是临床观察和皮肤镜检查中最常见的发现。纵向隆起、麻点、色痕和裂状出血在皮肤镜下表现较好。临床上未发现线性不平衡带。结论耳镜检查对甲癣和甲扁平苔藓有重要的诊断价值。
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The role of dermoscopy in the diagnosis of nail affection of psoriasis and lichen planus
Background Nail disorders comprise ∼10% of all dermatological conditions. Because diagnosis is not always possible by clinical means alone, additional diagnostic procedures may be required at times. Dermoscopy of nails (onychoscopy) has shown promising results in diagnosing various nail disorders. Aim To study the dermoscopic nail findings in psoriasis and lichen planus. Patients and methods A total of 80 patients with clinically evident psoriasis and lichen planus of nail were included in this study. They were classified into two groups: group 1 included 40 patients with nail psoriasis and group 2 included 40 patients with nail lichen planus. All patients were examined clinically and by dermoscope for criteria of psoriasis and lichen planus of the nails. Results In psoriatic patients, pitting is the commonest finding observed clinically and by dermoscope. Splinter hemorrhage, pitting, leukonychia, longitudinal ridging, oil drop sign, and onycholysis are better visualized by dermoscopy, and dilated hyponychial capillaries are detected only by dermoscopy. In patients of lichen planus, longitudinal ridging is the commonest finding observed clinically and by dermoscopy. Longitudinal ridging, pitting, chromonychia, and splinter hemorrhage are better seen by dermoscopy. Linear dyschromic bands are not detected clinically. Conclusion Onychoscopy can provide valuable diagnostic information in cases of nail psoriasis and nail lichen planus.
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