[{"Title":"参考文献","UniqueID":"v44326242_zh","Index":1.0,"Summary":"

1.Faergemann J, Baran R.Epidemiology, clinical presentation and diagnosis of onychomycosis. Br J Dermatol. 2003;149 Suppl 65:1-4.doi:10.1046/j.1365-2133.149.s65.4.x

","HeadType":"G_Head","SchemeItemProp":"","Children":[]},{"Title":"先天性指甲疾病","UniqueID":"v103464229_zh","Index":2.0,"Summary":"

一些先天性外胚层发育不良的患者无指甲（无甲）。

","HeadType":"F_Head","SchemeItemProp":"","Children":[]},{"Title":"与系统性疾病或暴露相关的指甲疾病和营养不良","UniqueID":"v103464237_zh","Index":3.0,"Summary":"

普卢默-文森综合征（由严重且未治疗缺铁性贫血导致的食管蹼）常伴有匙状甲（指甲凹陷呈匙状）。应跟踪患者是否出现呼吸消化道恶性肿瘤。

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"系统性甲营养不良参考文献","UniqueID":"v103464258_zh","Index":1.0,"Summary":"

普卢默-文森综合征（由严重且未治疗缺铁性贫血导致的食管蹼）常伴有匙状甲（指甲凹陷呈匙状）。应跟踪患者是否出现呼吸消化道恶性肿瘤。

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"与皮肤病相关的甲营养不良","UniqueID":"v103464270_zh","Index":4.0,"Summary":"

在 银屑病 患者中，指甲可能出现多种改变，包括不规则的点状凹陷、油斑（局部变色为棕黄色）、指甲部分与甲床分离（甲分离）、甲板增厚和碎裂、甲半月红斑和裂片形出血。甲银屑病可作为孤立现象或皮肤银屑病的特征出现。指甲银屑病也是导致银屑病关节炎的一个危险因素。

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"皮肤病参考文献","UniqueID":"v103464297_zh","Index":1.0,"Summary":"

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"指甲变色","UniqueID":"v103464324_zh","Index":5.0,"Summary":"

化疗药物（尤其是紫杉烷类）可导致黑甲（甲板着色），可表现为弥散性或横向条纹。一些药物还可产生特征性的甲颜色改变。

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"指甲变色参考","UniqueID":"v103464353_zh","Index":1.0,"Summary":"

化疗药物（尤其是紫杉烷类）可导致黑甲（甲板着色），可表现为弥散性或横向条纹。一些药物还可产生特征性的甲颜色改变。

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"甲中部营养不良(甲中部管状营养不良)","UniqueID":"v103464362_zh","Index":6.0,"Summary":"

甲中部营养不良的特点是横向延伸的指甲小裂缝，形似常青树的树枝。裂缝和脊类似于习惯抽动甲畸形（是由其他手指摩擦或抠挖指甲引起重复创伤导致的甲基质损伤形成甲中部营养不良）。甲中部营养不良的病因不明，某些病例可能与创伤相关。部分病例的发病可能与频繁使用需指甲重复敲击操作的数码设备相关。若患者避免可能导致重复轻度创伤的行为时以0.1％他克莫司睡前外用阻断治疗有效。

","HeadType":"F_Head","SchemeItemProp":"","Children":[]},{"Title":"线状黑甲","UniqueID":"v103464366_zh","Index":7.0,"Summary":"

纵行黑甲表现为从近端甲褶皱和角质层延伸至远侧甲板游离末端的纵向色素沉着带。色素沉着是由于黑色素细胞在指甲基质中沉积黑色素所致。黑色素的沉积通过黑色素细胞激活（指甲细胞中黑色素的产生增加）或黑素细胞增生（指甲基质中黑色素细胞的产生增加）而增加。

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"线状黑甲参考文献","UniqueID":"v103464376_zh","Index":1.0,"Summary":"

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"甲分离","UniqueID":"v103464385_zh","Index":8.0,"Summary":"

甲分离表现为甲板与甲床分离或甲板完全缺失。它可表现为药物反应的一种表现，出现在服用四环素类药物（光毒性甲分离）、阿霉素、5-氟尿嘧啶、心血管药物（特别是普拉洛尔和卡托普利）、氯唑西林和头孢噻啶（少见）、甲氧苄氨嘧啶/磺胺甲噁唑、双氟尼酸、阿维A酯、吲哚美辛、异烟肼、灰黄霉素以及异维A酸的患者身上。单纯(与其他指甲或皮肤疾病无关)甲分离也可能是由于接触刺激物引起的，例如经常接触水或柑橘类水果或化学物质。手部和手指的刺激性接触性皮炎也可能导致甲分离( 1 )。分离的甲床可能有 Candida albicans 感染，但去除病因后不管是否治疗 Candida，都将导致疾病的缓解。

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"甲剥离参考文献","UniqueID":"v103464394_zh","Index":1.0,"Summary":"

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"钳形指甲畸形","UniqueID":"v103464400_zh","Index":9.0,"Summary":"

钳形指甲畸形是一种甲板的横向过度弯曲。最常见的病因是甲癣、银屑病、甲肿瘤、骨关节炎以及鞋子不合脚。系统性红斑狼疮、川崎病、终末期肾病和一些遗传综合征（如先天性甲沟炎）也有报道。由于指甲板弯曲到手指或脚趾的尖端，所以患者通常会在指甲边缘感到疼痛。目前尚无确定的治疗方法可供选择，但是许多外科手术技术已经取得成功（ 1 , 2 , 3 )。

","HeadType":"F_Head","SchemeItemProp":"","Children":[{"Title":"钳形指甲畸形参考文献","UniqueID":"v103464412_zh","Index":1.0,"Summary":"

","HeadType":"G_Head","SchemeItemProp":"","Children":[]}]},{"Title":"指甲粗糙脆裂","UniqueID":"v103464424_zh","Index":10.0,"Summary":"

表现为粗糙、斑块状指甲。可出现在斑秃、扁平苔藓、特异性皮炎和银屑病患者。儿童常见。当存累及所有指甲时，指甲粗糙脆裂通常被称为二十甲营养不良。当它发生于儿童时，往往会自行消退。发生在成人的，针对潜在的病因治疗。诊断的一个线索是指甲摸起来像砂纸一样粗糙。

","HeadType":"F_Head","SchemeItemProp":"","Children":[]},{"Title":"指甲肿瘤","UniqueID":"v103464432_zh","Index":11.0,"Summary":"

良性和恶性肿瘤均可累及甲单元，导致甲营养不良。良性肿瘤包括黏液样囊肿、脓性肉芽肿、血管球瘤。及恶性肿瘤如 Bowen病、鳞状细胞癌和恶性黑素瘤。当怀疑恶性肿瘤时，强烈建议进行快速活检或转诊活检。

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