Private practice, Bellinzona, Switzerland.
University of Miami, Miller School of Medicine, Miami, Florida.
J Am Acad Dermatol. 2020 Dec;83(6):1717-1723. doi: 10.1016/j.jaad.2020.02.056. Epub 2020 Feb 26.
Lichen planus is a benign inflammatory disorder of unknown etiology that may affect the skin, mucosae, scalp, and nails. When the nails are affected, it may lead to permanent destruction with severe functional and psychosocial consequences. Therefore, prompt diagnosis and early treatment are essential, even in mild cases. There are currently no guidelines for the management of nail lichen planus and the published literature on treatment is limited. The aim of this review is to provide practical management recommendations for the classical form of nail lichen planus, especially when restricted to the nails. Topical treatment has poor short-term efficacy and may cause long-term side effects. Instead, intralesional and intramuscular triamcinolone acetonide should be considered first-line therapies. Oral retinoids are second-line choices, and immunosuppressive agents may also be considered.
扁平苔藓是一种病因不明的良性炎症性疾病,可能影响皮肤、黏膜、头皮和指甲。当指甲受到影响时,可能会导致永久性破坏,带来严重的功能和社会心理后果。因此,即使是轻度病例,也需要及时诊断和早期治疗。目前,尚无针对指甲扁平苔藓的管理指南,并且已发表的治疗文献也很有限。本综述的目的是为经典型指甲扁平苔藓提供实用的管理建议,尤其是当指甲仅限于指甲时。局部治疗的短期疗效较差,且可能引起长期副作用。相反,应首先考虑皮损内和肌肉内注射曲安奈德。口服类维 A 酸是二线选择,免疫抑制剂也可考虑。