Adigun Chris G, Shoaf Hannah
Dr. Adigun is with the Dermatology & Laser Center of Chapel Hill in Chapel Hill, North Carolina.
Ms. Shoaf is with the Center on Science & Technology Policy at Duke University in Durham, North Carolina.
J Clin Aesthet Dermatol. 2020 Dec;13(12):18-20. Epub 2020 Dec 1.
Multiple cases have reported onychodystrophy secondary to acrylic nails. We present a case of onychodystrophy with psoriasiform nail changes, including onycholysis, splinter hemorrhages, hyperkeratosis, and nail plate thinning, caused by gel manicures. Histopathological analysis of the nail plate and subungual debris revealed neutrophils in the absence of fungal elements. Although the presence of neutrophils in the nail plate material in conjunction with characteristic psoriatic nail changes suggested a diagnosis of psoriasis, certain key features of nail psoriasis, including oil spots, salmon patches, and pitting, were notably absent. The development of these nail changes following gel manicure and pedicure application and the improvement of the onychodystrophy with topical and intralesional steroids support the diagnosis of psoriasiform onychodystrophy.
已有多例关于丙烯酸指甲继发甲营养不良的报道。我们报告一例由凝胶美甲引起的甲营养不良伴银屑病样甲改变，包括甲剥离、裂片形出血、角化过度和甲板变薄。甲板和甲下碎屑的组织病理学分析显示有中性粒细胞，未见真菌成分。虽然甲板材料中存在中性粒细胞并伴有典型的银屑病甲改变提示银屑病诊断，但银屑病甲的某些关键特征，包括油滴状斑点、鲑鱼斑和甲凹点，明显缺失。这些甲改变在凝胶美甲和修脚后出现，且外用和皮损内注射类固醇后甲营养不良有所改善，支持银屑病样甲营养不良的诊断。
