Department of Human and Hereditary Pathology and Pediatric Science, Institute of Dermatology, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
J Eur Acad Dermatol Venereol. 2012 Nov;26(11):1354-9. doi: 10.1111/j.1468-3083.2011.04289.x. Epub 2011 Oct 6.
Psoriasis is a chronic inflammatory skin disease affecting 2.0-6.5% of the European population. Although the most striking clinical features of psoriasis involve the skin, other organs including nails and joints may be affected in a substantial proportion of patients. Literature reports nail involvement in 10-56% of psoriatic patients, with common physical and social impairment. However, the precise prevalence of specific clinical features of nail psoriasis is somewhat under-reported.
Our cross-sectional study aimed at describing the prevalence and the clinical features of nail involvement in adult psoriatic patients in a psoriasis referral centre in northern Italy.
A total of 178 (124 men, 54 women) consecutive adult patients (≥18 years old) with psoriasis were included. Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores were calculated for each patient. Relevant medical history was recorded.
Nail involvement was present in 137 (99 men, 38 women) patients (76.9%). The most common nail abnormality was onycholysis, followed by crumbling, subungual hyperkeratosis, pitting and discoloration. Pitting and onycholysis were the most prevalent patterns observed in fingernails, whereas onycholysis and crumbling were the most frequent changes detected in toenails. The most frequently and severely affected nails were the fourth fingernail and the first toenail. The average PASI score was higher in individuals with nail involvement (12.0 vs. 8.7, P = 0.06). Nail changes were present in 85.7% of patients with psoriatic arthritis.
Our study confirms that nail involvement may be overlooked in psoriasis patients. Different psoriatic patterns in the nail affect specific digits more frequently.
银屑病是一种影响欧洲 2.0-6.5%人群的慢性炎症性皮肤病。尽管银屑病最显著的临床特征涉及皮肤，但其他器官，包括指甲和关节，可能在相当一部分患者中受到影响。文献报道银屑病患者指甲受累的比例为 10-56%，常见的身体和社交障碍。然而，指甲银屑病的具体临床特征的准确患病率有些被低估了。
我们的横断面研究旨在描述意大利北部一家银屑病转诊中心成年银屑病患者指甲受累的患病率和临床特征。
共纳入 178 例（124 名男性，54 名女性）连续的成年银屑病患者（≥18 岁）。对每位患者计算银屑病面积和严重程度指数（PASI）和指甲银屑病严重程度指数（NAPSI）评分。记录相关病史。
137 例（99 名男性，38 名女性）患者存在指甲受累（76.9%）。最常见的指甲异常是甲剥离，其次是甲碎裂、甲下过度角化、凹点和变色。凹点和甲剥离是最常见的手指甲异常模式，而甲剥离和甲碎裂是最常见的脚趾甲变化。最常受累和最严重的指甲是第四手指甲和第一脚趾甲。指甲受累患者的平均 PASI 评分较高（12.0 比 8.7，P = 0.06）。指甲改变见于 85.7%的银屑病关节炎患者。
我们的研究证实，指甲受累可能在银屑病患者中被忽视。指甲中的不同银屑病模式更常影响特定的指甲。
