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首页> 外文期刊>American Journal of Dermatopathology >Nail Anatomy, Nail Psoriasis, and Nail Extensor Enthesitis Theory: What Is the Link?
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Nail Anatomy, Nail Psoriasis, and Nail Extensor Enthesitis Theory: What Is the Link?

机译：指甲解剖，指甲牛皮癣和指甲伸肌诱滞炎理论：链接是什么？

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The concept of the nail unit as a musculoskeletal appendage has become popular in the dermatological and rheumatological literature. However, an exact knowledge of the characteristics of mesenchyme surrounding the nail such as the composition of the collagen and elastic fibers and their arrangement is fundamental before one can propose a constitutive model. To the best of my knowledge, there is no study in the literature concerning the elastic network of the ligamentous connective tissue of the base of the distal phalanx. This study by means of elastic stains demonstrates that the so-called superficial, deep, and lateral laminae of the extensor tendon correspond to 3 different microanatomic structures: the nail dermis and its fibrous root, the subcutaneous proximal nail fold, and the periosteum. The complex fascial and adipose connective tissue of the proximal nail fold surrounds the matrical dermis and could viewed as a kind of suspensory system for the proximal nail unit. Such suspensory system protects the nail matrix epithelium from the biomechanical strain of the extensor mechanism. Near the ulnar and radial edge of the base of the phalanx, focal interconnections between the fibrous root of the apex of the matrix and the periosteum through a fascia-like structure are visible. In its most lateral zone, the matrical horns lie on a thick dermis connected to the interosseous ligament. Such lateral laminar system serves as anchoring ropes for the vault of the nail plate. The nail-extensor enthesitis theory relies on an oversimplified anatomy because the nail unit is an epidermal appendage with a specialized connection with the lateral periosteum, but not a musculoskeletal appendage. Finally, I would like to emphasize, the practical importance of recognizing the matrical hypoderm. In nail surgery, the interface between the matrical nail dermis and its submatrical loose connective tissue is potentially a new, relatively superficial, surgical cleaving plane, beside the classical deep surgical procedure usually extending to the periosteum. Recognition of this additional cleaving plane leads to an optimal nail tangential biopsy.
机译：指甲单位作为肌肉骨骼阑尾的概念在皮肤病学和风湿病学文献中变得流行。然而，围绕钉子围绕纤维和弹性纤维的组成的间质特征的精确知识及其布置在一个本构模型之前是基本的。据我所知，文献中没有研究关于远端蝴蝶基碱的韧带连接组织的弹性网络。本研究通过弹性污渍表明延伸肌腱的所谓浅，深，薄层，3种不同的微灭虫结构：钉真人和其纤维根，皮下近端钉褶和骨膜。近端钉褶的复杂鉴状和脂肪结缔组织周围围绕基质真皮，并且可以被视为近端指甲单元的一种悬挂系统。这种悬浮术系统免受伸肌机构的生物力学应变保护钉子上皮。靠近乌拉南碱的尺寸和径向边缘，可见基质顶点的纤维根系和通过筋膜的结构的纤维根系之间的焦互连。在其最横向区域中，基质喇叭位于连接到侧孔韧带的厚实的皮革上。这种横向层状系统用作锚固绳索用于钉板的拱顶。指甲延伸诱滞炎炎理论依赖于过度简化的解剖学，因为钉单位是具有与外膜外侧的专门连接的表皮阑尾，但不是肌肉骨骼阑尾。最后，我想强调，识别母体皮下肌的实际重要性。在钉手术中，基质钉真皮和其淹没的宽松连接组织之间的界面可能是一种新的相对肤浅的手术切割平面，除了通常延伸到骨膜的经典深层外科手术。识别该额外的切割平面导致最佳的指甲切线活检。

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