20甲营养不良患者的甲病理诊断分析

目的探讨临床诊断的20甲营养不良患者的病理改变特征,明确病因,指导治疗。方法 23例20甲营养不良患者,临床表现为获得性单纯性20甲损害,甲板表面有许多纵嵴,失去光泽不透明,似砂纸样外观,甲板增厚或变薄,真菌检查阴性。采用纵行甲活检手术方法获取甲组织标本,观察甲单位病理改变。结果 23例患者中病理改变符合甲银屑病4例,甲扁平苔藓3例,甲非特异性湿疹样变16例。发病年龄以青中年发病人数占绝对优势(73.91%);病程<2年者占21.74%,2～10年者占69.57%,>10年者占8.70%。结论甲单位病理检查能对20甲营养不良患者进行病理诊断,其病因包括甲银屑病、甲扁平苔藓以及甲非特异性湿疹样变,为下一步选择治疗药物提供重要依据。

The Nail Pathologic Analysis on the Patients of Twenty-nail Dystrophy

Objective To investigate the pathologic characteristic of twenty-nail dystrophy and analyze the cause of disease for guiding treatment.Methods A total of 23 patients with acquired and simplex damage of twenty nails,presented with obvious and massive ridge,lack of luster,rough-ening likened to sandpaper,thin or thick on nail surface,mycology examination revealed negative,were enrolled.Tissue samples were obtained by longitudinal nail biopsy to observe the pathologic change of nails.Results According to pathologic change,these cases had been diagnosed as 4 case of nail psoriasis,3 cases of nail lichen planus and 16 cases of nail nonspecific eczematous changes.The onset time were young adults were 73.91%.The course of disease was less than 2 years were 21.74%,2~10 years were 65.97%,more than 10 years were 8.70%.Conclusion The nail unit pathologic examination could help diagnosis of twenty-naildystrophy pathologically.Main causes of hail dystrphy include nail psoriasis,nail lichen planus and nail non-specific eczematous changes.The pathologic changes provide important evidence for the therapy.