Dermatology Department, Faculty of Medicine, Cairo University, and Cairo Leprosy Hospital, Cairo, Egypt.
J Eur Acad Dermatol Venereol. 2011 Mar;25(3):290-5. doi: 10.1111/j.1468-3083.2010.03783.x.
Nail changes in leprotic patients are not specific to leprosy, and may be observed in other peripheral neuropathies. Diabetes is one of the diseases that present with nail dystrophy secondary to peripheral neuropathy, vasculopathy, trauma and infections. Therefore, nail changes in diabetic neuropathy are expected to be very similar to that of leprosy.
To evaluate the frequency and pattern of nail changes in Egyptian leprotic patients with the different spectrums of the disease, and to compare nail changes in leprosy with those seen in patients with diabetic neuropathy.
The study included 115 leprosy patients and 60 patients with diabetic peripheral neuropathy. Nail examination was thoroughly carried out and various nail changes were recorded including the location of the involved nails (fingers, toes).
Our study detected similar incidence of nail changes in both multibacillary (MB) (86%) and paucibacillary (PB) patients (86%). Flag sign (alternating horizontal bands of whitish and pinkish discoloration of the nail) observed in our study was not reported before. It was more commonly seen in MB patients (21%) than in PB patients (14%). Our results also revealed that the nail changes were more commonly seen in leprosy patients (86%) than in diabetic patients (68%).
Nail changes in leprosy are multifactorial, and could be related to one or more of the following: neuropathy, endarteritis, trauma, drugs or superimposed infections. Nail changes in leprosy may be used as an additional clue that helps in the diagnosis.
麻风病患者的指甲变化并非特异性的，也可能在其他周围神经病变中观察到。糖尿病是一种因周围神经病变、血管病变、创伤和感染而导致指甲营养不良的疾病。因此，糖尿病性周围神经病患者的指甲变化预计与麻风病非常相似。
评估埃及不同疾病谱麻风病患者指甲变化的频率和模式，并比较麻风病和糖尿病性周围神经病患者的指甲变化。
本研究纳入了 115 例麻风病患者和 60 例糖尿病性周围神经病患者。对指甲进行了彻底检查，并记录了各种指甲变化，包括受累指甲的位置（手指、脚趾）。
我们的研究发现，多菌型（MB）（86%）和少菌型（PB）患者（86%）的指甲变化发生率相似。我们的研究观察到了以前未报道过的“旗帜征”（指甲的水平白色和粉红色交替变色），它在 MB 患者中更为常见（21%），而在 PB 患者中较少见（14%）。我们的结果还表明，麻风病患者的指甲变化更为常见（86%），而糖尿病患者的指甲变化则较少见（68%）。
麻风病的指甲变化是多因素的，可能与以下一种或多种因素有关：神经病变、动脉炎、创伤、药物或合并感染。指甲变化可作为有助于诊断的额外线索。
