Involvement of Nail Apparatus in Pemphigus Vulgaris in Ethnic Poles Is Infrequent
Involvement of Nail Apparatus in Pemphigus Vulgaris in Ethnic Poles Is Infrequent
复制标题
DOI：
10.3389/fmed.2018.00227
复制
发表时间：
2018-08-14
影响因子：
3.9
通讯作者：
Dmochowski, Marian
中科院分区：
文献类型：
--
作者：
Pietkiewicz, Pawel;Bowszyc-Dmochowska, Monika;Dmochowski, Marian
寻常型天疱疮病变有局限于自然身体孔口周围的趋势。目的分析寻常型天疱疮甲器受累情况。对67名患有寻常型天疱疮的波兰族患者进行了回顾性评价。使用临床数据、H+E组织学、拔除的头皮毛发和/或病灶周围组织的直接免疫荧光（也用于IgG 1和IgG 4沉积物评价）、镶嵌基质和/或猴食管的间接免疫荧光、桥粒芯蛋白1/3的单分析物ELISA或多分析物ELISA的组合诊断寻常型天疱疮。67例患者中有9例（13.4%; 3名女性和6名男性）发现甲器受累。6例患者（2名女性，4名男性）发现指甲周围病变，而仅3例患者（1名女性，2名男性）发现趾甲周围病变。我们的患者的指甲器官变化包括，按频率顺序，甲沟炎，指甲变色，甲破裂，Beau线，甲周肿胀，甲脱落，交叉脊，甲松解，和粗甲。在有和无甲器病变的PV患者中，患者回忆的发病与直接免疫荧光诊断寻常型天疱疮之间的平均时间无统计学差异。在这篇文章中，甲周受累的分子和免疫学原理进行了讨论。我们的单中心研究表明，指甲器参与是罕见的寻常天疱疮在波兰族。由于寻常型天疱疮的甲器病变在临床上可能类似于甲癣，因此很难做出正确的诊断，特别是当其他病变被忽视或误解时。
Pemphigus vulgaris lesions have a tendency to localize around natural body orifices. The aim here was to analyze the involvement of nail apparatus in pemphigus vulgaris. Sixty seven ethnic Poles suffering from pemphigus vulgaris on photographic files archiving initial presentation were retrospectively evaluated. Pemphigus vulgaris was diagnosed using combination of clinical data, H+E histology, direct immunofluorescence of plucked scalp hair and/or perilesional tissue also for IgG1 and IgG4 deposits evaluation, indirect immunofluorescence on mosaic substrate and/or monkey esophagus, mono-analyte ELISA with desmoglein 1/3 or multi-analyte ELISA. The nail apparatus involvement was found in 9 of 67 patients (13.4%; 3 females and 6 males). Periungual fingernail lesions were found in 6 patients (2 females, 4 males), whereas periungual toenail lesions in just 3 patients (1 female, 2 males). Our patients nail apparatus changes included, by order of frequency, paronychia, nail discoloration, onychorrhexis, Beau lines, periungual hemorrhages, onychomadesis, cross-ridging, onycholysis, and trachyonychia. The average time between the onset, as recalled by patients, and the diagnosis of pemphigus vulgaris with direct immunofluorescence was not statistically different in PV patients with and without nail apparatus lesions. In this article the molecular and immunological rationale for of periungual involvement is discussed. Our single-center study suggests that nail apparatus involvement is infrequent in pemphigus vulgaris in ethnic Poles. Due to the fact that nail apparatus lesions in pemphigus vulgaris may clinically resemble onychomycosis, giving the proper diagnosis can be difficult particularly when other lesions are overlooked or misinterpreted.