Department of Dermatovenereology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Wuhou District, Chengdu, Sichuan Province, 610041, China.
Department of Dermatovenereology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Wuhou District, Chengdu, Sichuan Province, 610041, China, Department of Dermatology, Zigong Fourth Hospital, Zigong, Sichuan Province, 643000, China.
Eur J Dermatol. 2020 Aug 1;30(4):362-371. doi: 10.1684/ejd.2020.3841.
Nail involvement is common in psoriasis patients, however, there are few detailed studies of clinical parameters related to disease severity and therapeutic efficacy.
Our retrospective study aimed to describe the prevalence and clinical characteristics in nail psoriasis patients and determine possible associations between multiple clinical parameters and disease severity or therapeutic efficacy.
A total of 89 nail psoriasis patients were included and investigated using dermoscopy. The Nail Psoriasis Severity Index (NAPSI) and the Nijmegen-Nail Psoriasis Activity Index tool (N-NAIL) were used to measure the severity and improvement of nail psoriasis. Severity and efficacy-related parameters were also analysed.
Subungual hyperkeratosis (94.4%) was the most commonly observed nail feature. Coexistence of pitting and leukonychia, transverse grooves and thickening were more commonly observed in juveniles than adults. Patients with more severe nail psoriasis were more likely to have more nails affected and develop discolouration. The efficacy of treatment after fixed intervals of treatment was analysed. Most clinical parameters were not related to therapeutic efficacy, including disease duration, age at onset and number of nail signs. However, after six months of treatment, the presence of transverse grooves was shown to be associated with better efficacy. Based on comparison of NAPSI and N-NAIL scores relative to the first visit, the presence of transverse grooves, longitudinal ridges or discolouration were associated with better efficacy.
Clinicians should be aware of the clinical parameters related to severity and the use of therapeutic efficacy in choosing individualized treatment and predicting prognosis.
指甲受累在银屑病患者中很常见，但关于与疾病严重程度和治疗效果相关的临床参数的详细研究较少。
我们的回顾性研究旨在描述指甲银屑病患者的患病率和临床特征，并确定多个临床参数与疾病严重程度或治疗效果之间的可能关联。
共纳入 89 例指甲银屑病患者，并使用皮肤镜进行检查。使用指甲银屑病严重程度指数（NAPSI）和尼姆斯根指甲银屑病活动指数工具（N-NAIL）来衡量指甲银屑病的严重程度和改善情况。还分析了严重程度和疗效相关参数。
甲板下过度角化（94.4%）是最常见的指甲特征。凹陷和白甲、横沟和增厚在青少年中比成年人更常见。指甲银屑病更严重的患者更有可能有更多的指甲受累和变色。分析了固定治疗间隔后的治疗效果。大多数临床参数与治疗效果无关，包括疾病持续时间、发病年龄和指甲征象数量。然而，在治疗六个月后，横沟的存在与更好的疗效相关。基于与首次就诊时的 NAPSI 和 N-NAIL 评分的比较，横沟、纵向脊或变色的存在与更好的疗效相关。
临床医生应了解与严重程度相关的临床参数以及治疗效果的应用，以选择个体化治疗和预测预后。
