Universidad Mayor, Santiago, Chile.
Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile.
J Ultrasound Med. 2024 Apr;43(4):781-788. doi: 10.1002/jum.16410. Epub 2024 Jan 8.
To describe the ultrasonographic features of nail lichen planus (NLP), which, so far, have not been reported in the literature.
A retrospective single-center study of NLP patients' color Doppler ultrasound examinations was performed between March 2014 and January 2023. Inclusion criteria were patients ≥15 years with a confirmed clinical diagnosis of NLP in sequential order. Exclusion criteria included concomitant systemic or local cutaneous or nail diseases and systemic or local nail treatments before the ultrasound examination. The ultrasound protocol included the examination of all fingernails or toenails following the reported protocol for dermatologic ultrasound examinations at high and ultra-high frequencies. Patient demographics and ultrasound features of the nail bed, periungual region, nail plate, and regional vascularity were registered and analyzed statistically.
A total of 36 patients met the criteria. All cases presented thickened and decreased echogenicity of the nail bed. A hypoechoic halo surrounding the origin of the nail plate was present in 78% of cases. Exactly 58% of patients presented decreased echogenicity of the proximal periungual dermis, and 86% showed thickening of the periungual dermis. Hypervascularity of the nail bed was seen in 94% of cases. The mean maximum thickness of vessels, the peak systolic velocity of the arterial vessels, and other blood flow findings are provided.
Ultrasonography can support the diagnosis of NLP, which benefits the non-invasive discrimination of nail conditions and can avoid the potential permanent scars derived from nail biopsies. Furthermore, ultrasound may be a powerful tool to monitor this disease's treatment.
描述甲扁平苔藓（NLP）的超声特征，迄今为止，文献中尚未报道过这些特征。
对 2014 年 3 月至 2023 年 1 月期间进行的 NLP 患者彩色多普勒超声检查进行回顾性单中心研究。纳入标准为连续顺序临床确诊为 NLP 的年龄≥15 岁的患者。排除标准包括伴有系统性或局部皮肤或甲疾病以及在超声检查前进行系统性或局部甲治疗的患者。超声方案包括按照皮肤科超声检查报告的方案在高频和超高频下检查所有指甲或趾甲。登记并统计分析患者的人口统计学数据以及甲床、甲周区、甲板和区域性血管的超声特征。
共有 36 名患者符合标准。所有病例均表现为甲床增厚和回声降低。78%的病例存在围绕甲板起源的低回声晕。58%的患者存在近端甲周真皮回声降低，86%的患者存在甲周真皮增厚。94%的病例存在甲床血管增多。提供了血管最大厚度、动脉血管收缩期峰值速度和其他血流发现的平均值。
超声检查可支持 NLP 的诊断，有助于对指甲状况进行非侵入性鉴别，并可避免源于指甲活检的潜在永久性疤痕。此外，超声可能是监测这种疾病治疗的有力工具。
