皮肤镜在甲真菌病与炎症性甲病诊断及鉴别诊断中的应用  

Dermoscopy in the Diagnosis and Differential Diagnosis of Onychomycosis and Inflammatory Nail Disorders

作　　者：王诗琪 李航[1] 李若瑜[1] WANG Shiqi;LI Hang;LI Ruoyu(Department of Dermatology&Venereology,Peking University First Hospital,National Clinical Research Center for Skin and Immune Diseases,Research Center for Medical Mycology,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses,Peking University,Beijing 100034,China)

机构地区：[1]北京大学第一医院皮肤性病科真菌室,国家皮肤与免疫疾病临床医学研究中心,北京大学真菌和真菌病研究中心,皮肤病分子诊断北京市重点实验室,北京100034

出　　处：《中国皮肤性病学杂志》2020年第12期1443-1448,共6页The Chinese Journal of Dermatovenereology

基　　金：“十三五”科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”课题(2018ZX10712001)。

摘　　要：甲真菌病与炎症性甲病传统的诊断和鉴别诊断方法包括真菌学检查和组织病理检查。但由于真菌学检查敏感性低,依赖于真菌实验室设备和经验丰富的真菌学检验专家,而组织病理具有有创、疼痛、耗时、花费高的缺点,限制了它们的临床应用。近年来,皮肤镜逐渐应用于甲病的临床实践,对提高甲真菌病和炎症性甲病的临床诊断与评估具有重要价值。本文从皮肤镜观察甲部病变的基本原则与方法、皮肤镜在甲真菌病诊断与鉴别诊断中的应用、皮肤镜在炎症性甲病诊断及鉴别诊断中的应用三个方面予以综述。Traditional methods of diagnosis and differential diagnosis of onychomycosis and inflammatory nail disorders include mycological examination and histopathological examination.However,mycological tests,with a relatively low sensitivity,rely on fungal laboratory equipment and experienced experts in mycological tests.Histopathology has the disadvantages of being invasive,painful,time-consuming,and expensive,which limits their clinical application.In recent years,dermoscopy has gradually been applied to the clinical practice of the nail disorders which is of great value in improving the clinical diagnosis and evaluation of onychomycosis and inflammatory nail diseases.This article reviews the basic principles and methods of dermoscopic observation of nail lesions,the application of dermoscopy in the diagnosis and differential diagnosis of onychomycosis,and the application of dermoscopy in the diagnosis and differential diagnosis of inflammatory nail diseases.

关 键 词：皮肤镜 甲真菌病 炎症性甲病 甲银屑病 甲扁平苔藓 诊断 鉴别诊断 

分 类 号：R758.72[医药卫生—皮肤病学与性病学] R756.4[医药卫生—临床医学]