扁平苔藓是一种病因复杂的多方面疾病。多达10%的扁平苔藓患者涉及指甲。虽然大多数病例是轻微的,由于疾病的快速进展,可能会发生严重后果,疤痕的高风险,以及对指甲结构的不可逆损伤。至少一个指甲的永久性损伤发生在大约4-12%的指甲扁平苔藓患者中。在这篇叙述性评论中,我们强调指甲扁平苔藓的病理生理学,这种疾病的紧急性质,以及不同临床表现的频谱。一般诊断为指甲疾病,特别是指甲扁平苔藓,正在迅速发展。这篇综述全面介绍了文献中报道的非侵入性和侵入性诊断技术和治疗方案,强调所用药物的有效性和安全性,相关证据,以及在规划和提供适当治疗时应考虑的因素。还总结了美学和伪装选项的作用。
Lichen planus is a multifaceted disease of complex etiopathogenesis. Nails are involved in up to 10% of patients with lichen planus. Although most cases are mild, serious consequences may occur due to rapid progression of the disease, the high risk of scarring, and the resulting irreversible damage to the nail structure. Permanent damage of at least one nail occurs in approximately 4-12% of patients with nail lichen planus. In this narrative
review, we emphasize the pathophysiology of nail lichen planus, the emergent nature of the disease, and the spectrum of different clinical manifestations. Diagnosis of nail disease in general, and of nail lichen planus in particular, is rapidly evolving. This
review provides a comprehensive account of the non-invasive and invasive diagnostic techniques and treatment options reported in the literature, with emphasis on the efficacy and safety of the drugs used, the associated evidence, and the factors to be taken into account in planning and providing adequate treatment. The role of aesthetic and camouflage options is also summarized.