Schlesinger N, Katz M, Ingber A
Rheumatology Service, UMDNJ/New Jersey Medical School, Newark, NJ 07103, USA.
Br J Dermatol. 2002 May;146(5):836-9. doi: 10.1046/j.1365-2133.2002.04696.x.
Involvement of the nail unit in pemphigus vulgaris (PV) is thought to be rare.
To determine the frequency of nail changes among patients with PV.
Nail changes were recorded in patients with PV and were analysed retrospectively. Biopsies were taken from the nail bed and nail matrix for histological and immunofluorescence observations. Microscopic (potassium hydroxide) examination and fungal culture were performed.
Nail changes were present in 30 of 64 (47%) patients with PV. Sixteen patients had onychomycosis and 14 had nail changes due to PV. These included onychomadesis, discoloration, deformity, onychorrhexis, onycholysis, subungual haemorrhage, subungual hyperkeratosis and paronychia. Onychomycosis affected fingernails and toenails, but changes due to PV occurred only in fingernails, most commonly on the thumb and index finger. No connection was found between the patient's occupation and nail involvement, and there was no correlation with the severity or duration of PV. In a control group of 64 patients of similar sex and age, only two had non-specific fingernail changes.
Nail changes in PV may be more frequent than previously thought.
寻常型天疱疮（PV）累及甲单位被认为较为罕见。
确定PV患者甲改变的发生率。
记录PV患者的甲改变并进行回顾性分析。从甲床和甲母质取材进行组织学和免疫荧光观察。进行显微镜（氢氧化钾）检查和真菌培养。
64例PV患者中有30例（47%）出现甲改变。16例患者有甲癣，14例患者有PV所致的甲改变。这些改变包括甲脱落、变色、畸形、甲纵裂、甲剥离、甲下出血、甲下角化过度和甲沟炎。甲癣累及手指甲和脚趾甲，但PV所致的改变仅发生于手指甲，最常见于拇指和示指。未发现患者职业与甲受累之间存在关联，且与PV的严重程度或病程无关。在一个由64名年龄和性别相仿的患者组成的对照组中，只有2例有非特异性手指甲改变。
PV的甲改变可能比之前认为的更为常见。
