Department of Dermatology, Venereology and Cosmetology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Dermatology, Peking University First Hospital, Beijing, China.
Mycoses. 2024 Apr;67(4):e13721. doi: 10.1111/myc.13721.
Psoriatic patients may experience the coexistence of onychomycosis (OM). However, the evaluation of OM in psoriatics has been hindered by potential clinical differences from OM in non-psoriatics.
To assess and compare dermoscopic features between toenail OM in psoriatic and in non-psoriatic patients.
Between September 2020 and September 2023, dermoscopy was conducted on 183 affected toenails by OM in psoriatics and 232 affected toenails by OM in non-psoriatics in two centres. The dermoscopic characteristics were compared using the Chi-squared test.
Among toenail OM cases in psoriatic subjects, the most prevalent dermoscopic features included pitting (147/183, 80.33%) and subungual hyperkeratosis (118/183, 64.48%). Conversely, toenail OM in non-psoriatics was characterized by subungual hyperkeratosis (175/232, 75.43%) and nail spikes (139/232, 59.91%). Comparative analysis revealed a significantly higher occurrence of pitting (80.33% vs. 15.96%, p < .001), periungual telangiectasis (22.40% vs. 4.74%, p < .001), oil patches (12.57% vs. 0.43%,p < .001) and transverse grooves (43.72% vs. 28.45%,p < .01) in toenail OM in psoriatics. Furthermore, toenail OM in psoriatics exhibited a significantly lower frequency of yellow structureless area (13.11% vs. 42.67%, p < .001), nail spikes (43.17% vs. 59.91%, p < .01), ruin appearance of sulphur nugget (8.20% vs. 31.03%, p < .001), dotted/blocky haemorrhage (6.01% vs. 20.69%,p < .001) and partial onycholysis (32.79% vs. 46.98%, p < .01).
Dermoscopic features of toenail OM in psoriatic and non-psoriatic patients exhibit notable differences. OM in psoriatics shows a higher frequency of pitting and periungual telangiectasis, while a lower frequency of yellow structureless areas and nail spikes under dermoscopy.
银屑病患者可能会同时患有甲真菌病（OM）。然而，由于银屑病患者与非银屑病患者 OM 的临床差异，对银屑病患者 OM 的评估受到了阻碍。
评估和比较银屑病和非银屑病患者甲真菌病的甲下皮镜特征。
2020 年 9 月至 2023 年 9 月，在两个中心对 183 例银屑病患者和 232 例非银屑病患者的 183 个受 OM 影响的趾甲和 232 个受 OM 影响的趾甲进行了甲下皮镜检查。使用卡方检验比较皮镜特征。
在银屑病患者的趾甲 OM 病例中，最常见的皮镜特征包括凹点（147/183，80.33%）和甲下过度角化（118/183，64.48%）。相反，非银屑病患者的趾甲 OM 表现为甲下过度角化（175/232，75.43%）和甲刺（139/232，59.91%）。对比分析显示，凹点（80.33%比 15.96%，p<0.001）、甲周毛细血管扩张（22.40%比 4.74%，p<0.001）、油斑（12.57%比 0.43%，p<0.001）和横向沟（43.72%比 28.45%，p<0.01）在银屑病患者的甲真菌病中更常见。此外，银屑病患者的趾甲 OM 中黄色无结构区（13.11%比 42.67%，p<0.001）、甲刺（43.17%比 59.91%，p<0.01）、硫磺块破坏外观（8.20%比 31.03%，p<0.001）、点状/块状出血（6.01%比 20.69%，p<0.001）和部分甲分离（32.79%比 46.98%，p<0.01）的频率明显较低。
银屑病和非银屑病患者甲真菌病的甲下皮镜特征存在显著差异。银屑病患者的 OM 表现为凹点和甲周毛细血管扩张的频率较高，而黄色无结构区和甲刺的频率较低。
