120例儿童甲脱落病例相关因素分析

中华皮肤科杂志 ›› 2013, Vol. 46 ›› Issue (8): 583-585.

120例儿童甲脱落病例相关因素分析

李垣君¹,张金桃²,朱冰³,⁴,李军³,周爱珍³,陈谨萍²

1. 山西省儿童医院
2. 广州市儿童医院皮肤科
3. 广州市妇女儿童医疗中心
4.

收稿日期:2012-08-16 修回日期:2013-03-20 出版日期:2013-08-15 发布日期:2013-08-01
通讯作者: 李垣君 E-mail:liyuanjun77@163.com

Factors associated with onychomadesis in children: analysis of 120 cases

Received:2012-08-16 Revised:2013-03-20 Online:2013-08-15 Published:2013-08-01
Contact: Yuan-Jun LI E-mail:liyuanjun77@163.com

摘要/Abstract

摘要： 【摘要】目的探讨儿童甲脱落的相关因素，了解甲脱落与手足口病之间的关系。方法以无甲脱落的血管瘤患儿120例作为对照，回顾性研究120例甲脱落患儿。荧光逆转录-PCR对咽拭子标本进行病毒学检测。采用SPSS16.0软件进行统计分析，卡方检验检测分类资料。结果甲脱落患儿年龄（3.19 ± 2.06）岁，发病前曾有85例患过手足口病（70.83%），且距离甲脱落发生时间为4 ~ 8周。甲脱落与手足口病之间有明显关联（OR：7.621，95% CI：4.292 ~ 13.531）。甲脱落与手足口病期间有无发热史及热峰的高低无明显关联；与血清微量元素异常、潜在疾病史、退热类药物使用史及抗生素使用史之间均无统计学意义（均P > 0.05）。检测伴有甲脱落发生的手足口病患儿咽拭子标本68例，病毒检出率为39.7%。柯萨奇病毒A16型9例，肠道病毒71型3例，肠道病毒属其他型别肠道病毒15例。结论甲脱落可能是手足口病的一个并发症。

关键词: 手足口病, 甲脱落, 儿童

Abstract: LI Yuan-jun, ZHANG Jin-tao*, ZHU Bing, LI Jun, ZHOU Ai-zhen，CHEN Jin-ping. *Department of Dermatology, Guangzhou Women and Children′s Medical Center, Guangzhou 510120, China 【Abstract】 Objective To analyse factors associated with onychomadesis in children, and to evaluate the relationship between onychomadesis and hand-foot-mouth disease（HMFD）. Methods A retrospective study was performed. Clinical data were collected from 120 children with onychomadesis （average age, 3.19 ± 2.06 years） and 120 sex- and age-matched patients with hemangioma. Viral detection was realized by real-time reverse transcription-PCR in throat swab specimens. Data were analyzed by chi-square test using the SPSS 16.0 software. Results Of the 120 patients with onychomadesis, 85 （70.83%） had a history of HMFD, which was 4 to 8 weeks prior to the occurrence of onychomadesis. Onychomadesis was strongly correlated with HMFD （OR, 7.621，95% CI, 4.292 － 13.531）, but uncorrelated with the occurrence and peak of fever, abnormality of serum trace elements, existence of latent diseases, or the use of antipyretic drugs or antimicrobial drugs during the clinical course of HMFD （all P > 0.05）. Several viruses were detected in 39.7% of 68 throat swab specimens from patients with HMFD accompanied by onychomadesis, which included Coxsackievirus A16 in 9 patients, enterovirus 71 in 3 patients and unidentified enteroviruses in 15 patients. Conclusion Onychomadesis appears to be a complication of HMFD.

Key words: Onychomadesis

李垣君张金桃朱冰李军周爱珍陈谨萍. 120例儿童甲脱落病例相关因素分析[J]. 中华皮肤科杂志, 2013, 46(8): 583-585.

参考文献

1. Daniel CR, Scher RK. Nail changes secondary to systemic drugs or ingestants. J Am Acad Dermatol 1984,10 (2 Pt 1):250–258. 2. Bodman MA. Miscellaneous nail presentations. Clin PediatrMed Surg 1995,12（2）:327–346. 3. 赵辨．临床皮肤病学[M]．第3版．南京：江苏科学技术出版社，2001:954 4. Clementz GC, Mancini AJ. Nail matrix arrest following hand-foot-mouth disease: a report of five children. Pediatric Dermatol 2000,17(1):7–11. 5. Bernier V, Labrèze C, Bury F, et al. Nail matrix arrest in the course of hand, foot and mouth disease. Eur J Pediatr. 2001,160(11):649-651. 6. Salazar A, Febrer I, Guiral S, et al. Onychomadesis outbreak in Valencia, Spain, June 2008. Euro Surveill. 2008,13(27). pii: 18917. 7. Redondo Granado MJ, Torres Hinojal MC, Izquierdo López B. [Post viral onychomadesis outbreak in Valladolid]. [Article in Spanish] .An Pediatr (Barc). 2009,71(5):436-439. 8. Osterback R, Vuorinen T, Linna M, et al. Coxsackievirus A6 and hand, foot, and mouth disease, Finland.Emerg Infect Dis. 2009,15(9):1485-1488. 9. 朱冰，钟家禹，夏慧敏,等.2008年广州地区手足口病的病原学研究[J].中华儿科杂志,2010,48（2）:127-130. 10. 刘民,刘闯.手足口病的流行病学特征及预防[J].中国皮肤性病学杂志,2010,24（7）:591-594 . 11. Guimbao J, Rodrigo P, Alberto MJ, et al. Onychomadesis outbreak linked to hand, foot, and mouth disease, Spain, July 2008. Euro Surveill.2010,15(37). pii: 19663. 12. Wei SH, Huang YP, Liu MC, et al. An outbreak of coxsackievirus A6 hand, foot, and mouth disease associated with onychomadesis in Taiwan, 2010. BMC Infect Dis. 2011, 11:346. 13. Davia JL, Bel PH, Ninet VZ, et al.Onychomadesis outbreak in Valencia, Spain associated with hand, foot, and mouth disease caused by enteroviruses.Pediatr Dermatol. 2011,28(1):1-5. 14. Bracho MA, González-Candelas F, Valero A, et al. Enterovirus co-infections and onychomadesis after hand, foot, and mouth disease, Spain, 2008.Emerg Infect Dis. 2011,17(12):2223-2231.

[1]	徐教生向欣徐子刚邢嬛马琳. 儿童原发性皮肤骨瘤11例临床分析[J]. 中华皮肤科杂志, 2019, 52(8): 525-528.
[2]	梁源刘玲玲王珊赵作涛马琳向欣顾恒陈崑王华易红陈谨萍张金桃姚志荣郭一峰陈戟程颖朱学骏. 0.03%他克莫司软膏长期间歇维持治疗儿童特应性皮炎的多中心随机对照临床研究[J]. 中华皮肤科杂志, 2019, 52(8): 519-524.
[3]	路坦王珊王榴慧李萍舒虹申春平吴瑶罗珍缪丽敏王红兵焦磊田晶彭晓霞赵牧童刘盈聂晓璐马琳何黎. 一种含青刺果油等提取物的润肤剂改善儿童特应性皮炎缓解期临床症状的多中心、随机、平行对照临床研究[J]. 中华皮肤科杂志, 2019, 52(8): 537-541.
[4]	张韡陈浩徐秀莲姜祎群曾学思孙建方. 致残性全硬化性硬斑病六例临床病理特点分析[J]. 中华皮肤科杂志, 2018, 51(8): 561-563.
[5]	黄丹鞠梅常宝珠陈旭张小华朱艳周亚男许南陈崑顾恒. 51例女童尖锐湿疣临床分析[J]. 中华皮肤科杂志, 2018, 51(5): 363-365.
[6]	孙娟徐教生尉莉韩晓锋. 儿童水疱型毛母质瘤16例临床病理分析[J]. 中华皮肤科杂志, 2018, 51(12): 855-858.
[7]	喻苏婷周鹏飞王奔高宇. 308 nm准分子激光联合外用药物治疗儿童白癜风疗效观察[J]. 中华皮肤科杂志, 2016, 49(8): 595-598.
[8]	苏海辉苑世萍段志华王晓艳. 反射式共聚焦显微镜在儿童皮肤扁平苔藓诊断中的应用[J]. 中华皮肤科杂志, 2016, 49(6): 428-430.
[9]	王海燕刘翠杰刘洪普. 幼儿亚急性皮肤型红斑狼疮一例[J]. 中华皮肤科杂志, 2016, 49(3): 217-218.
[10]	盛楠余美文许昌春姚煦宗文凯. 南京市2 ~ 6岁儿童荨麻疹现况调查[J]. 中华皮肤科杂志, 2015, 48(2): 125-127.
[11]	黄雷刘爱民戴宇文傅海东王晶晶毛建华. 儿童过敏性紫癜760例临床分析[J]. 中华皮肤科杂志, 2015, 48(1): 11-14.
[12]	丁艳何小解廖旺杨慧兰向伟党西强易著文. 系统性红斑狼疮患儿Epstein-Barr病毒基因异常表达的研究[J]. 中华皮肤科杂志, 2015, 48(1): 15-18.
[13]	范文葛. 男童尿道旁腺炎一例[J]. 中华皮肤科杂志, 2014, 47(9): 678-679.
[14]	阳芳郑利雄姚勇丰宋彪孙兆军冯思航房思宁. 手足口病愈后甲脱落九例分析[J]. 中华皮肤科杂志, 2014, 47(2): 128-129.
[15]	聂建军陈涛蒋存火李林. 儿童青斑血管炎一例[J]. 中华皮肤科杂志, 2014, 47(11): 827-827.