Romaszkiewicz Alicja, Bykowska Barbara, Zabłotna Monika, Sobjanek Michał, Sławińska Martyna, Nowicki Roman J
Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland.
Postepy Dermatol Alergol. 2018 Jun;35(3):309-313. doi: 10.5114/pdia.2017.68299. Epub 2018 Apr 24.
The role of a number of inherited, acquired and environmental factors has been identified to increase the risk of onychomycosis. The literature data on psoriasis as a risk factor are contradictory. The potential relationship between these pathologies is very important as it influences the patient management.
To evaluate the frequency of onychomycosis and etiological factors in patients with psoriasis compared to controls.
The studied group ( = 2427) included 2325 patients with nail abnormalities raising a clinical suspicion of nail onychomycosis (with no history of psoriasis) and 102 psoriatic inpatients. The control group included 100 patients with clinically normal nails. The assessment of psoriasis severity using Nail Psoriasis Severity Index (NAPSI) and Psoriasis Area and Severity Index (PASI) was performed in all psoriatic patients. The presence of fungi was confirmed in direct microscopy and culture.
A significantly higher incidence of onychomycosis was observed in psoriatic patients as well as in non-psoriatic patients with clinically abnormal nails compared to controls. The prevalence of onychomycosis did not differ significantly between psoriatic patients and non-psoriatic patients with nail alterations. The characteristics of isolated fungi differed significantly between psoriatic and non-psoriatic patients. NAPSI ≥ 40 and receiving systemic treatment increased the risk of onychomycosis in psoriatic patients.
The presented study showed a relatively high prevalence of onychomycosis in patients with psoriasis, what confirms the accuracy of performing screening mycological examination in this group. Further studies are warranted to evaluate the role of specific risk factors, explain the differences observed in previous studies and to determine optimal patient management.
已确定多种遗传、后天获得和环境因素会增加甲癣的发病风险。关于银屑病作为风险因素的文献数据相互矛盾。这些病症之间的潜在关系非常重要，因为它会影响患者的治疗管理。
评估银屑病患者与对照组相比甲癣的发病率及病因。
研究组（n = 2427）包括2325例有指甲异常、临床怀疑为甲癣（无银屑病病史）的患者和102例银屑病住院患者。对照组包括100例指甲临床正常的患者。对所有银屑病患者采用指甲银屑病严重程度指数（NAPSI）和银屑病面积和严重程度指数（PASI）评估银屑病严重程度。通过直接显微镜检查和培养确认真菌的存在。
与对照组相比，银屑病患者以及临床指甲异常的非银屑病患者中甲癣的发病率显著更高。银屑病患者与有指甲病变的非银屑病患者中甲癣的患病率无显著差异。银屑病患者和非银屑病患者分离出的真菌特征有显著差异。NAPSI≥40且接受全身治疗会增加银屑病患者患甲癣的风险。
本研究表明银屑病患者中甲癣的患病率相对较高，这证实了对该组患者进行真菌学筛查的准确性。有必要进一步研究以评估特定风险因素的作用，解释先前研究中观察到的差异，并确定最佳的患者治疗管理方案。
