甲营养不良的治疗进展

Treatment of onychodystrophy

甲营养不良是指各种因素造成的甲形态及结构异常，其临床发生率较高，可表现为甲变薄，浑浊，变形等，部分患者甚至可合并多种损害。甲营养不良的病因复杂，可与其他皮肤病如银屑病、湿疹以及全身疾病有关，另外，药物和局部因素也可引起。部分患者无明显诱因，称特发性甲营养不良。甲营养不良目前尚无理想的治疗方法。目前提倡针对病因施行相应对策。除了系统治疗外，还有局部用药、手术治疗。因甲板影响药物渗透，局部单独外用药物治疗的生物利用度低，近年来光动力疗法、Nd：YAG激光、点阵CO2激光联合外用药物的新型治疗方法显示出一定优势。

Onychodystrophy represents abnormal morphology and structure of nails caused by various factors, with a high incidence rate in clinic. It can manifest as nail thinning, turbidity, deformities and so on, and multiple nail damages can simultaneously occur in some patients. The etiology of onychodystrophy is complex. Onychodystrophy can be related to other skin diseases, such as psoriasis, eczema and systemic diseases, as well as drugs and local factors. Some patients developed onychodystrophy without obvious causes, which was called idiopathic onyehodystrophy. The treatment of onychodystrophy is challenging, and there are no ideal methods at present. Therapeutic approaches aimed at etiology are recommended. Besides systemic therapy, topical therapy and surgical treatment are available. Since nail plate can decrease the permeability of drugs, topical application of drugs alone has low bioavailability. Recently, newly developed methods have shown great potential, such as photodynamic therapy, 1064-nm neodymium-doped yttrium aluminium garnet （Nd： YAG） laser, fractional CO2 laser combined with external application drugs.