Study of Nail Psoriasis and Dermoscopic Correlation With Dermoscopic and Modified Dermoscopic Nail Psoriasis Severity Indexes (dNAPSI and dmNAPSI)

Abstract

Background: Nail involvement in psoriasis may be assessed clinically, ultrasonologically, and dermoscopically. The aim of this study was to assess the dermoscopic features of nails in psoriasis, compare them with clinical findings, and correlate them with the Nail Psoriasis Severity Index (NAPSI) score. Methods: We recruited 120 patients with psoriatic nail changes for the study. The Psoriasis Area Severity Index (PASI) was used to assess the severity of disease. Clinical and dermoscopic (DermLite DL4, ×10, polarized and non-polarized) nail examination determined NAPSI, modified NAPSI (mNAPSI), and NAPSI determined with dermoscopic findings (dermoscopic NAPSI [dNAPSI] and dermoscopic modified NAPSI [dmNAPSI]) were used to assess severity of nail involvement. Results: Subungual hyperkeratosis (50.8%) and nail plate thickening (56.7%) were the commonest clinical nail changes found, and dermoscopically, they were subungual hyperkeratosis and pitting (68.3% each). The average median with interquartile range of PASI and NAPSI scores were 7.5 [5.7-10.8] and 8.0 [6-12], respectively. NAPSI scores increased significantly with the increase in PASI scores (P 10) and predict joint involvement and their severity

Keywords

• nail psoriasis
• nail psoriasis severity index
• psoriasis area severity index
• dermoscopy
• onychoscopy