PDF(Pubmed)
Abstract：
Nail lichen planus (NLP) is a chronic inflammatory disease of unknown etiology and has been recognized as a nail potentially critical disorder, which can be severe and rapidly worsen with irreversible scarring. Currently, the treatment options are limited based on disease progression. High-potency topical or intralesional corticosteroids are commonly considered first-line therapeutic options; however, these therapies are unsuitable for all patients with NLP, especially those with extensive lesions. As a potential therapeutic target for inflammatory skin diseases, Janus kinase (JAK) inhibitors can suppress both type-1 and type-2 cytokines, thereby reducing the immune response and resultant inflammation. Recent studies have suggested benefit in cutaneous lichen planus and lichen planopilaris with oral JAK inhibitors. Here, we report a case of severe NLP that exhibited a favorable response to tofacitinib treatment. A 41-year-old woman presented to our clinic with a 2-year history of nail dystrophy of all fingers of both hands. The NLP was finally confirmed by histopathology and the above clinical features. After the informed consent signature, tofacitinib monotherapy, 5 mg twice a day, was then begun, and after 6 months, the appearance of her nails had a significant improvement.
摘要：
指甲扁平苔藓（NLP）是一种病因不明的慢性炎症性疾病，已被认为是指甲潜在的危重性疾病，这可能是严重的，并迅速恶化，不可逆转的疤痕。目前,根据疾病进展,治疗方案有限.高效局部或病灶内皮质类固醇通常被认为是一线治疗选择；然而，这些疗法不适合所有NLP患者，尤其是那些有广泛病变的人。作为炎症性皮肤病的潜在治疗靶点，Janus激酶（JAK）抑制剂可以抑制1型和2型细胞因子，从而减少免疫反应和由此产生的炎症。最近的研究表明，口服JAK抑制剂对皮肤扁平苔藓和扁平苔藓有益。这里,我们报告了1例严重NLP,对托法替尼治疗有良好反应.一名41岁的妇女出现在我们的诊所，有2年的双手所有手指的指甲营养不良史。最终通过组织病理学和上述临床特征证实了NLP。知情同意书签字后，托法替尼单一疗法，5毫克，一天两次，然后开始，六个月后，她的指甲外观有了显著的改善。
