Study On The Typing Of Vitiligo With Leukonychia Punctata Epidemiology And TCM Syndrome Differentiation

Objective Vitiligo is a kind of non-congenital primary chronic disease, or a skin disorder characterized by depigmentation,which is quite common in dermatology department.Up to present,there are only a few researches on the fingernails change with vitiligo,especially on the punctate leukonychia.This article is mainly aimed at figuring out the seasonal pathogenesis of punctate leukonychia by analyzing the characteristics of vitiligo,TCM syndrome differentiation of vitiligo within different seasons through the data of punctate leukonychia occurrence rate and the clinical features observed from vitiligo patients so as to explore the pre-signal of vitiligo and contribute to the early intervention.Methods 585 adult cases from March of 2014 to February of 2015 with preliminary diagnosis with vitiligo in Wuhan First Hospital are selected in the research and 680 healthy cases are selected randomly from the Health Examination center in Wuhan First Hospital. Exclusion does not conform to the standards of cases,the actual collection of 554 patients of vitiligo and 670 cases of healthy people.Check and get records on the fingernails color of healthy people and patients diagnosed with vitiligo in the first visit, collect patients’ information by questionnaires and analysis its TCM syndrome differentiation.Analyze the statistics with SPSS16.0 software.Result ①Within the 670 healthy cases(control group),39(5.82%) of them have punctate leukonychia,among which the male occurrence rate is 5.56% and female occurrence rate is 6.16%,the result is meaningless because the comparative value is more than 0.05(P>0.05). When dividing the groups by age,the result getting through different ages is X2 =11.13,P<0.05,which is meaningful;②Within the 554 vitiligo patients(observation group),150(27.08%) of them have punctate leukonychia,among which the female occurence rate is 32.84% and male occurrence rate is 21.55%,higher in female than that in male and male to female ratio is 1:1.524,the result is meaningful because the comparative value is less than 0.05(P<0.05).Selecting randomly from these patients and then dividing the groups via age, the result getting from the comparison with groups is less than 0.05(P<0.05),which is meaningful;③Compared with control group, the occurrence rate of punctate leukonychia of observation group is much higher,with the value of X2=1.049,P<0.01,which is absolutely meaningful;④The occurrence rate of punctate leukonychia in apring is 31.91%, 32.05% in summer,27.67% in autumn and 11.22% in winter,the rate in summer is obviously higher than the other 3 seasons,then comes to the spring,the value got via comparison of season is X2 =25.52,P<0.05,which is meaningful;⑤The occurrence rate in progressive stage is 29.59% and 22.97% in the stable stage, the value via comparison is X2 =19.44,P<0.05,which is meaningful. Meanwhile,the occurrence rate in non-segmental type is 25.74%,the rate in segmental type is 34.13%,25.00% in mixed type and 19.61% in others.The value got via comparison among different types is X2 =1.478,P<0.01,which is meaningful;and among the non-segmental the occurrence rate in sporadic type is 34.13%,22.58% in generalized type,24.70% in facial & acral type,20.00% in mucosal type;the value got from the subtypes of non-segmental type is X2 =2.00,P>0.05, which is meaningless;⑥When dividing the 554 vitiligo patients into three types with TCM syndrome differentiation theory,namely:feng xue xiang bo syndrome,gan yu qi zhi syndrome and gan shen bu zu syndrome,the value got via comparison is X2 =47.88,P<0.01,which is meaningful;⑦The occurrence rate on the left hand is 31.41% and 44.95% on the right hand,the value via comparison is X2=13.29 8,P<0.05,which is meaningful.Conclusion ①The occurrence rate in observation group is obviously higher than control group,there must be some connection between punctuate leukonychia and vitiligo prone physique;②There is a difference on the occurrence rate between male and female in the control group,latter is higher than former and the occurrence age is among 22-41 years old;And the occurrence rate in right hand is higher than left,so we can speculate that may be related to the Chinese habit which the right hand activity amplitude is greater than left;And there is meaningless in different nails;③The occurrence of punctuate leukonychia in vitiligo is related with season changes、TCM sydrome types and mainly in progressive stage.We presume the occurrence of punctuate leukonychia may be one of the pre-signal of vitiligo,and may also be identified easily progressive state in vitiligo,therefore punctuate leukonychia provide some help in prediction and severity of vitiligo.