Salomon Joanna, Szepietowski Jacek C, Proniewicz Alina
Department of Dermatology and Venereology, University of Medicine, Wrocław, Poland.
J Cutan Med Surg. 2003 Jul-Aug;7(4):317-21. doi: 10.1007/s10227-002-0143-0. Epub 2003 Jul 28.
Psoriasis is a widespread skin disorder in which nail involvement is a common symptom. Many psoriatic patients have nail changes morphologically resembling onychomycosis.
The present study was undertaken (1) to evaluate the frequency of nail involvement in psoriatic patients, (2) to assess the types of nail changes in psoriasis, (3) to find eventual relationships between nail involvement and some clinical parameters, and finally (4) to determine the prevalence of fungal nail infections in psoriatic individuals.
One hundred six patients hospitalized in our department due to exacerbation of psoriasis participated in the study. Each patient underwent dermatologic examination with special attention paid to the nail changes. In any case of abnormalities clinically suspected of fungal infection, further mycological investigations were performed.
Nail changes were present in 83 patients (78.3%) with psoriasis. The most common nail abnormality observed on both fingernails and toenails was subungual hyperkeratosis. Hyperkeratosis, onychorrexis, and discoloration of nail plates were observed significantly more often on toenails. Pitting and longitudinal ridges were significantly more frequent on fingernails. Patients with psoriatic nail dystrophy were significantly older than psoriatic patients without nail abnormalities. Nails were involved statistically more often in patients with arthropathic psoriasis. Positive mycological cultures were obtained from 18% of patients with nail changes. The most commonly isolated fungi were molds.
Dystrophic nails are frequently found in psoriatic individuals, especially those suffering from arthropathic psoriasis. Subungual hyperkeratosis and pitting are the most typical lesions. It is difficult to assess definitively whether psoriasis is a predisposing factor to the development of fungal infections of the nails.
银屑病是一种常见的皮肤病，指甲受累是其常见症状。许多银屑病患者的指甲改变在形态上类似于甲癣。
本研究旨在（1）评估银屑病患者指甲受累的频率，（2）评估银屑病指甲改变的类型，（3）寻找指甲受累与一些临床参数之间的潜在关系，最后（4）确定银屑病患者甲真菌病的患病率。
因银屑病加重而在我科住院的106例患者参与了本研究。每位患者均接受了皮肤科检查，特别关注指甲改变。对于临床上怀疑有真菌感染异常的任何病例，均进行了进一步的真菌学检查。
83例（78.3%）银屑病患者存在指甲改变。在手指甲和脚趾甲上观察到的最常见的指甲异常是甲下角化过度。脚趾甲上观察到角化过度、甲纵嵴和甲板变色的情况明显更多。手指甲上的点状凹陷和纵嵴明显更常见。银屑病甲营养不良患者明显比无指甲异常的银屑病患者年龄大。关节病型银屑病患者的指甲受累在统计学上更为常见。18%有指甲改变的患者真菌培养呈阳性。最常分离出的真菌是霉菌。
银屑病患者常出现甲营养不良，尤其是关节病型银屑病患者。甲下角化过度和点状凹陷是最典型的病变。很难确切评估银屑病是否是指甲真菌感染发生的一个易感因素。
