Lindsay甲的诊治现状和进展

Diagnosis and Treatment of Lindsay’s Nail: Current Status and Advances

Lindsay甲是系统性疾病引起的一种甲改变,特征性改变是指甲近端呈白色,甲半月变得不明显,而指甲远端呈红棕色;常见于慢性肾功能不全的患者,也可能与克罗恩病、白塞病、肝硬化等疾病相关;其发病机制目前尚不明确。在已发表的文献中,没有看到白色条带的宽度与肾功能衰竭的严重程度或持续时间、年龄、性别、蛋白尿或其他临床参数之间存在相关性,但可能与局部甲床下毛细血管功能及管腔内红细胞的流动等因素相关,比较重要的有红细胞膜的变形性和血管内皮黏附特性等。甲颜色的改变需要与其他可引起甲变白的多种疾病进行鉴别,特别是临床表现非常接近的Terry甲情况。目前尚未发现特殊的治疗方法,治疗仅针对合并的慢性肾脏疾病等进行。本文将对Lindsay甲的临床表现、发病机制、鉴别诊断、治疗等进行综述,为Lindsay甲的相关研究提供理论参考依据。

Lindsay′s nail is a nail change caused by systemic diseases.The characteristic changes are that the proximal nails are white, the lunula is less obvious, and the distal nails are reddish-brown.It is common in patients with chronic renal insufficiency and may also be associated with Crohn′s disease, Behcet′s disease, liver cirrhosis, and other diseases.The pathogenesis remains unclear.There is no correlation between the width of the white stripe and the severity or duration of renal failure, age, sex, proteinuria or other clinical parameters in the published literature.However, it may be related to the local subnail bed capillary function and the flow of red blood cells in the lumen.The changes in the color of the nail need to be identified from the many other diseases that can cause it to turn white, especially Terry′s nail.At present, the treatment is only for complicated chronic kidney disease.This review summarizes the clinical manifestations, pathogenesis, differential diagnosis, and treatment of Lindsay′s nail and provides a theoretical reference for the research of Lindsay′s nail.