背景:麻风病是一种慢性肉芽肿性传染病,主要影响皮肤和周围神经,由专性细胞内细菌麻风分枝杆菌引起。这种疾病已经在最近的研究中的几篇综述文章中进行了讨论,但就我们所知,只有少数人解决了麻风病对指甲的影响,尤其是那些检查麻风病人指甲皮肤镜特征的人。
目的:我们旨在记录麻风病患者的指甲变化,并通过皮肤镜检查确定任何具体发现。
方法:这是一项在HasanSadikin医院皮肤科和性病诊所进行的观察性研究,西爪哇,印度尼西亚,从2023年3月到2023年5月。所有患者都有麻风病病例,诊断基于临床和细菌学检查。招聘是通过总抽样进行的。使用手持式皮肤镜(HeineDELTA20TDermatoscope)以偏振模式在10倍放大倍数下对所有手指甲和脚趾甲进行皮肤镜检查,而没有链接液以记录皮肤镜特征。
结果:共有19名患者,15例由于麻风病而发生指甲变化。15名患者中,13例患者为男性。25岁以下的患者有更多的指甲变化。大多数患者的疾病持续时间超过两年。9名患者的手指和脚趾均受累。在这项研究中,最常见的皮肤镜特征是纵向脊。在这项研究中发现的其他皮肤镜特征是横线,甲状腺溶解症,纵向黑甲,白甲,甲下出血,甲下角化过度,甲沟炎,和onychorrexis。
结论:麻风病患者中发现了指甲变化,并且具有多种临床表现。应进行皮肤镜检查以评估麻风病的指甲变化。
BACKGROUND: Leprosy is a chronic granulomatous infectious disease, mainly affecting the skin and peripheral nerves, caused by the obligate intracellular bacteria Mycobacterium leprae. The disease has been discussed in several review articles in recent research, but as far as we know, only a few have addressed the effects of leprosy on nails, especially those who examine the dermoscopic features of nails in leprosy patients.
OBJECTIVE: We aimed to document nail changes in leprosy patients and identify any particular findings through dermoscopic examination.
METHODS: This was an observational study conducted in the Dermatology and Venereology Clinic of Hasan Sadikin Hospital, West Java, Indonesia, from March 2023 through May 2023. All patients have established cases of leprosy, and the diagnosis is based on clinical and bacteriological examinations. Recruitment was done through total sampling. Dermoscopic examination of all fingernails and toenails was performed at 10x magnification using a handheld dermatoscope (Heine DELTA 20 T Dermatoscope) in polarized mode without the linkage fluid to document the dermoscopic features.
RESULTS: Of a total of 19 patients, 15 had nail changes due to leprosy. Out of 15 patients, 13 patients were male. Patients below 25 years old had more nail changes. Most of the patients had a duration of disease greater than two years. Both fingers and toes were involved in nine patients. In this study, the most common dermoscopic feature found was the longitudinal ridge. Other dermoscopic features found in this study were transverse lines, onycholysis, longitudinal melanonychia, leukonychia, subungual hemorrhage, subungual hyperkeratosis, anonychia, and onychorrexis.
CONCLUSIONS: Nail changes are found in leprosy patients and have a wide variety of clinical appearances. A dermoscopy should be performed to assess nail changes in leprosy.