Gao Jing, Shen Changbing, Ko Randy, Guo Yajun, Shen Xue, Cui Yong, Yang Chunjun
Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.
Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.
Indian J Dermatol. 2020 Jan-Feb;65(1):11-16. doi: 10.4103/ijd.IJD_193_18.
Subungual splinter hemorrhage (SSH) is a common nail disorder and is difficult to differentiate from other nail diseases because of their similar characteristics. The epidemiological study of SSH is lacking and it is unclear whether SSH needs treatment or not.
The aims of this study were to observe the clinical characteristics of SSH of toenails in Chinese adults and to provide a reference for the diagnosis and prognosis of patients with SSH.
We collected and followed up 63 SSH patients who were diagnosed through dermoscopic examination. The clinical and dermoscopic characteristics, disease course, and recovery results were recorded. Data sets were analyzed through the use of SPSS 16.0. Literature concerning SSH were reviewed and compared with the results in this study.
Sixty-three SSH patients were included with an age range of 17-58 years. Nearly 93.7% of SSH patients occurred in the right, left, or right and left first toenails; 66.7% of SSH patients occurred only in one toenail; there were 60.3% of SSH patients with a clear stimulus causing it and 31.8% of SSH patients with five types of comorbidities. The common characteristics of dermoscopy showed a reddish brown or brown stain with a clear boundary visible under the nail in which the color gradually faded outward from the center, with no blue or white structure. After following up for 24 weeks, the disappearance of hemorrhage was observed in 95.2% of SSH patients. For the recovered SSH patients, data analysis showed no significant difference in the course of SSH in males and females ( = 0.645); the statistical analysis showed that there was no significant correlation ( = -0.002) between age and course in recovered SSH patients ( = 0.986).
It is unnecessary to do any special treatment during the 1 year. Measures ought to be taken for SSH patients if the course of the disease exceeds more than 1 year.
甲下裂片形出血（SSH）是一种常见的甲病，因其特征相似，难以与其他甲病相鉴别。目前缺乏对SSH的流行病学研究，且尚不清楚SSH是否需要治疗。
本研究旨在观察中国成年人趾甲SSH的临床特征，为SSH患者的诊断和预后提供参考。
我们收集并随访了63例经皮肤镜检查确诊的SSH患者。记录其临床和皮肤镜特征、病程及恢复结果。使用SPSS 16.0对数据集进行分析。回顾有关SSH的文献，并与本研究结果进行比较。
纳入63例SSH患者，年龄范围为17 - 58岁。近93.7%的SSH患者发生在右、左或双侧的拇趾趾甲；66.7%的SSH患者仅发生在一个趾甲；60.3%的SSH患者有明确的诱发刺激因素，31.8%的SSH患者伴有五种合并症。皮肤镜的共同特征表现为甲下可见边界清晰的红棕色或棕色斑片，颜色从中心向外逐渐变淡，无蓝色或白色结构。随访24周后，95.2%的SSH患者出血消失。对于恢复的SSH患者，数据分析显示男性和女性的SSH病程无显著差异（P = 0.645）；统计分析表明，恢复的SSH患者年龄与病程之间无显著相关性（r = -0.002，P = 0.986）。
1年内无需进行任何特殊治疗。如果病程超过1年，应对SSH患者采取相应措施。
