咬甲癖合并纵行黑甲一例及皮肤镜表现

A case of onychophagia-induced longitudinal melanonychia and its dermoscopic features

16岁女性患者,手指甲板出现褐色纵行条带10年。患者有啃咬双手指甲习惯。皮肤科情况:多个手指甲甲板表面凹凸不平,右手中指甲板中央明显凹陷呈匙状;多个指甲甲板分布宽度不等的褐色纵行条带,甲板远端缺损呈锯齿状、散在暗红色碎片状斑点;甲周皮肤散在白色鳞屑。左手示指皮损组织病理示基底层黑素细胞无异常增生,其体积、形态均正常,黑素合成增加。诊断:①纵行黑甲:②咬甲癖。

A 16-year-old female patient presented with brown longitudinal bands on multiple fingernails for 10 years.The patient has the habit of biting her nails of both hands.Dermatological examination:the surface of digits nail plate is rough,and the middle nail of the right hand is Spoon-shaped.Both hands with longitudinal melanonychia involving jagged distal nail plates presented pinpoint hemorrhages on them.A small number of scales scattered around the nail.Histopathology of the left index finger showed that there is no proliferation of melanocytes in basal cell layer,their volum and shape are normal,and the melanocytes are activated to produce melanin.Diagnosis:longitudinal melanonychia and onychophagia.