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[指甲和牙齿的改变作为遗传性皮肤病的线索]

[Alterations in nails and teeth as a clue for genodermatoses].

作者信息

Itin P

机构信息

Dermatologie Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz,

出版信息

Hautarzt. 2014 Jun;65(6):513-9. doi: 10.1007/s00105-013-2713-z.

Abstract

BACKGROUND

There are about 10,000 monogenic diseases and around 30% demonstrate alterations in the skin and its appendages. As there are so many genetic different skin diseases, clear diagnosis is often very difficult.

AIM

The goal of this review is to give the clinicians some key features on nails and teeth which might help to identify rare genodermatoses.

DISCUSSION

In the daily work genodermatoses manifest more commonly as incomplete or oligosymptomatic syndromes than as complete symptom complexes. To diagnose a rare disorder in such situations, a knowledge of key features which are characteristic for a genodermatoses is essential, so that a diagnosis can be advanced and the underlying gene defect identified. Changes in nails and teeth sometimes may be useful as diagnostic key features. Both structures originate from ectoderm and therefore they often appear in combination in diseases with major ectodermal malformations. Enamel defects resembling the lines of Blaschko are highly suggestive for focal dermal hypoplasia, even if other important signs and symptoms are missing. Enamel defects combined with gingival fibromas are highly suggestive for tuberous sclerosis. On the other side, triangular lunulae with malformation and dystrophy of the nail plate suggests nail-patella syndrome.

摘要

背景

单基因疾病约有10000种,其中约30%表现为皮肤及其附属器的改变。由于存在众多遗传上不同的皮肤病,明确诊断往往非常困难。

目的

本综述的目的是为临床医生提供一些关于指甲和牙齿的关键特征,这可能有助于识别罕见的遗传性皮肤病。

讨论

在日常工作中,遗传性皮肤病更多地表现为不完全或症状较少的综合征,而非完整的症状复合体。在这种情况下诊断罕见疾病时,了解遗传性皮肤病的关键特征至关重要,以便能够推进诊断并识别潜在的基因缺陷。指甲和牙齿的变化有时可能作为诊断的关键特征。这两种结构均起源于外胚层,因此它们常常在具有主要外胚层畸形的疾病中同时出现。类似Blaschko线的釉质缺陷高度提示局灶性真皮发育不全,即使缺少其他重要体征和症状。釉质缺陷合并牙龈纤维瘤高度提示结节性硬化症。另一方面,甲半月呈三角形且甲板畸形和营养不良提示指甲-髌骨综合征。

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