Baran R, Juhlin L
Dermatology Unit, Cannes General Hospital, France.
J Am Acad Dermatol. 1987 Dec;17(6):1012-6. doi: 10.1016/s0190-9622(87)70291-6.
We have studied 15 patients with photo-onycholysis induced by tetracyclines, psoralens, or fluoroquinolones. Three distinct clinical subtypes of onycholysis were seen. Type I showed a half-moon-shaped separation that was concave distally. Type II had a circular notch opened distally and shaped as if the distal nail plate had acted as a convex lens. In type III the changes were located in the central part of the nail bed with no connection to the margins. Ultraviolet (UV) irradiation of normal fingernails with various wavelengths showed that 3% to 20% of the irradiation could penetrate the nail. The different patterns of photodamage might be caused by the nail acting as a lens. Less protection by lack of melanin and absence of sebum and stratum granulosum may favor penetration of UV irradiation and explain why the skin was not always affected.
我们研究了15例由四环素、补骨脂素或氟喹诺酮类药物引起的光线性甲剥离患者。观察到三种不同的临床甲剥离亚型。I型表现为半月形分离，远端呈凹形。II型有一个向远端开口的圆形切口，形状如同远端甲板起到了凸透镜的作用。III型的改变位于甲床中央部分，与边缘无连接。用不同波长对正常指甲进行紫外线（UV）照射显示，3%至20%的照射可穿透指甲。光损伤的不同模式可能是由于指甲起到了透镜的作用。缺乏黑色素、皮脂和颗粒层提供的保护较少，可能有利于紫外线照射的穿透，这也解释了为何皮肤并非总是受到影响。
