Siragusa M, Schepis C, Cosentino F I, Spada R S, Toscano G, Ferri R
Unit of Dermatology, Oasi Institute for Research on Mental Retardation and Brain Ageing (IRCCS), Via Conte Ruggero 73, 94018 Troina, Italy.
Br J Dermatol. 2001 Mar;144(3):557-60. doi: 10.1046/j.1365-2133.2001.04083.x.
It is well known that nails can be involved in some diseases of the central nervous system; however, no systematic study has been carried out in order to evaluate the incidence and the possible mechanisms of these nail changes in hemiplegia.
To study the presence of nail pathology specifically associated with hemiplegia and to evaluate its incidence and its temporal relationship with the onset of the neurological deficit.
In an open study, fingernails and toenails were examined by a dermatologist; 108 were patients with hemiplegia due to a stroke, consecutively admitted to our Department of Neurology between 1995 and 1998, and 121 were normal controls.
Onychodystrophy of fingernails and onychomycosis of toenails were found in both patients with hemiplegia and normal controls. However, three conditions (longitudinal reddish striation, neapolitan nails and unilateral clubbing) were only observed in some patients, always affecting fingernails of the limb affected by hemiplegia. Neapolitan nails were present in three (3%) patients with hemiplegia which had its onset 3-14 months earlier. Hemiplegia had occurred approximately 40 months earlier, on average, in six patients (6%) with longitudinal reddish striation, and 60-120 months prior to unilateral clubbing in another two patients (2%).
In this study we were able to assess the presence of three different fingernail conditions that were characteristically associated with hemiplegia (longitudinal reddish striation, neapolitan nails and unilateral clubbing), to evaluate their incidence and to study the delay with which these changes occur after a stroke.
众所周知，指甲可能与某些中枢神经系统疾病有关；然而，尚未进行系统研究以评估偏瘫患者指甲变化的发生率及可能机制。
研究与偏瘫特异性相关的指甲病变情况，并评估其发生率以及与神经功能缺损发作的时间关系。
在一项开放性研究中，由皮肤科医生检查手指甲和脚趾甲；108例为1995年至1998年间连续入住我院神经科的中风后偏瘫患者，121例为正常对照者。
偏瘫患者和正常对照者均发现有手指甲营养不良和脚趾甲甲癣。然而，三种情况（纵向红色条纹、那不勒斯甲和单侧杵状指）仅在部分患者中观察到，且总是累及偏瘫侧肢体的手指甲。三名（3%）偏瘫患者出现那不勒斯甲，其发病时间比指甲变化早3 - 14个月。平均而言，六名（6%）有纵向红色条纹的患者偏瘫发生时间比指甲变化早约40个月，另外两名（2%）患者出现单侧杵状指前60 - 120个月发生偏瘫。
在本研究中，我们能够评估三种与偏瘫特征性相关的不同手指甲情况（纵向红色条纹、那不勒斯甲和单侧杵状指）的存在情况，评估其发生率，并研究中风后这些变化出现的延迟时间。
