中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (6): 400-405.doi: 10.12144/zgmfskin202506400

• 论著 • 上一篇    下一篇

中重度斑块型银屑病甲损害特征及严重程度相关性分析

戚春燕1,3,佘昕妍2,蔡丽婷2,关则璞2,王晓华2,邱晓愉2   

  1. 1南方医科大学第一临床医学院，广东广州，510515；2南方医科大学皮肤病医院皮肤科，广东广州，510091；3广州市从化区妇幼保健院皮肤科，广东广州，510900
  • 出版日期:2025-06-15 发布日期:2025-05-21

Characteristics and severity correlation analysis of nail damage in moderate to severe plaque psoriasis

QI Chunyan1,3, SHE Xinyan2, CAI Liting2, GUAN Zepu2, WANG Xiaohua2, QIU Xiaoyu2   

  1. 1 The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; 2 Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou 510091, China; 3 Department of Dermatology, Guangzhou Conghua Maternal and Child Health Hospital, Guangzhou 510900, China
  • Online:2025-06-15 Published:2025-05-21

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摘要： 目的：总结中重度斑块型银屑病甲损害的临床特征、分析严重程度的相关因素以及其对患者生活质量、心理健康的影响。方法：采用问卷调查和量表评估（包括DLQI、NPQ10、HADS）收集2024年6～11月皮肤科就诊的中重度斑块型银屑病患者的人口学信息、疾病特征、生活质量及心理健康状况。根据甲损害严重程度（NAPSI评分）将患者分为轻度（0＜NAPSI≤40）和严重（NAPSI＞40）两组，分析其差异及相关因素。结果：共收集177例中重度斑块型银屑病患者，其中119例合并甲损害，甲损害表现主要为甲分离（95例），甲凹陷（84例），甲脆裂(71例)。与轻度甲损害组（54例）相比，严重甲损害组（65例）合并头部皮损、关节痛发生率、甲损害数目、甲损害病程、PASI评分、NPQ10评分更高，出现焦虑和抑郁比例更高，差异均具有统计学意义(均P＜0.05)。合并关节痛(OR=3.86,95% CI 1.41～10.55)、合并头部损害(OR =6.3,95% CI 1.74～22.84)，甲损害病程超过10年(OR =11.93,95% CI 2.53~56.16)，均与严重甲损害正相关（均P＜0.05）。结论：银屑病合并甲损害中甲分离最多见，甲损害的严重程度与合并头部皮损、关节痛、PASI评分、甲损害病程密切相关，并显著影响患者的生活质量和心理健康。

关键词: 甲银屑病, 甲损害程度, 生活质量, 焦虑, 抑郁

Abstract: Objective: To summarize the clinical characteristics and severity factors of nail damage in patients with moderate to severe plaque psoriasis, as well as its impact on quality of life and mental health. Methods: The demographic information, disease characteristics, quality of life, and mental health status of patients with moderate to severe plaque psoriasis who visited the dermatology outpatient clinic from June 2024 to November 2024 were collected through questionnaire survey and scale assessment (including DLQI, NPQ10, and HADS). Patients were divided into two groups based on the severity of nail involvement (NAPSI score): mild (0 ＜ NAPSI ≤ 40) and severe (NAPSI ＞ 40). Differences and correlations between the two groups were analyzed. Results: Among the 177 psoriasis patients, 119 exhibited nail involvement including onycholysis in 95 cases, onychodystrophy in 84 cases, brittle nails in 71 cases. Compared with the mild nail patients in 54 cases, the patients with severe nail (65 cases) had significantly higher incidence rates of head skin lesions and arthralgia, a greater number of nail involvements, longer duration of nail involvement, higher PASI scores, higher NPQ10 scores, and higher proportions of anxiety and depression, with all differences being statistically significant (PS＜0.05). The presence of arthralgia (OR=3.86, 95% CI 1.41-10.55), presence of head skin involvement (OR=6.3, 95% CI 1.74 - 22.84), and a duration of nail involvement exceeding 10 years (OR=11.93,95% CI 2.53-56.16) were all positively correlated with severe nail , (PS＜0.05). Conclusion: The onychia separation is the most common of nail damage in the patients with moderate to severe plaque psoriasis. The severity of nail damage is closely associated with head involvement, arthralgia, PASI score, and duration of nail involvement, which significantly impacts the quality of life and mental health of patients.

Key words: nail psoriasis, severity of nail impairment, quality of life, anxiety, depression