Zaouak Anissa, Gara Soumaya, Fenniche Samy, Hammami Houda
Department of Dermatology, Research Unit "Genodermatosis and Cancer" LR12SP03, Habib Thameur Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Skin Appendage Disord. 2021 Jun;7(4):315-317. doi: 10.1159/000514362. Epub 2021 Mar 22.
Bullous pemphigoid (BP) is the most frequent autoimmune blistering disorder. The immune reaction targets BP180 and BP230 antigens, 2 components of junctional adhesion complexes at the basement membrane zone. Clinical aspect includes multiple tense bullae on urticarial plaques of the skin. Although the nail apparatus may be affected by the immune process, nail changes have been rarely reported during BP. We report a case of a 72-year-old woman diagnosed with BP who subsequently developed a secondary nail loss of the 2 thumbs and the left middle finger. Also, she presented onycholysis of the fourth left finger with the aspect of roller-coaster of the proximal border at dermoscopy. Steroid therapy at high doses was ineffective and the nail atrophy was permanent.
大疱性类天疱疮（BP）是最常见的自身免疫性水疱性疾病。免疫反应针对BP180和BP230抗原，这是基底膜区连接黏附复合物的两个组成部分。临床表现包括皮肤荨麻疹斑块上出现多个紧张性水疱。虽然甲器可能受到免疫过程的影响，但在BP病程中很少有甲改变的报道。我们报告一例72岁女性，诊断为BP，随后继发双侧拇指和左手示指指甲脱落。此外，她左手环指出现甲分离，在皮肤镜检查下近端边缘呈过山车样外观。高剂量类固醇治疗无效，指甲萎缩是永久性的。
