Mashal Zeinab R, Elgamal Emad Eldin A, Zaky Mohamed S, Elsaie Mohamed L
Damietta Dermatology and Leprosy Hospital, Ministry of Health and Population, Damietta, Egypt.
Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Dermatol Res Pract. 2023 May 15;2023:4653177. doi: 10.1155/2023/4653177. eCollection 2023.
Nail psoriasis is a challenging chronic condition affecting patients functionally and psychologically. Nail involvement is observed in 15-80% of psoriatic patients with occasional presence of isolated nail psoriasis.
To evaluate dermoscopic features of nail psoriasis and correlate them clinically.
The study included fifty subjects with nail psoriasis. Psoriasis skin and nail severity was evaluated using psoriasis area severity index (PASI) and nail psoriasis severity index (NAPSI). Dermoscopy of the nails (onychoscopy) was performed, and features were recorded and analyzed.
The most common clinical and dermoscopic findings were pitting (86%) and onycholysis (82%). Among all dermoscopic features of nail psoriasis, only longitudinal striations and subungual hyperkeratosis were significantly higher in patients with moderate to severe psoriasis than in patients with mild psoriasis (=0.028; =0.042, respectively). PASI scores correlated positively but none significantly with NAPSI scores ( = 0.132, =0.360), and similarly, no significant correlation was observed between the duration of psoriasis and the dermoscopic NAPSI ( = 0.022, =0.879).
Dermoscopy can serve as a useful tool for early diagnosis of psoriatic nail changes not always visible to the naked eye and is a non-invasive easy-to-use confirmatory tool for nail changes in psoriatic disease or in isolated nail involvement.
甲银屑病是一种具有挑战性的慢性疾病，在功能和心理方面影响患者。15% - 80%的银屑病患者有甲受累情况，偶尔也会出现孤立性甲银屑病。
评估甲银屑病的皮肤镜特征并将其与临床情况相关联。
该研究纳入了50例甲银屑病患者。使用银屑病面积和严重程度指数（PASI）及甲银屑病严重程度指数（NAPSI）评估银屑病皮肤和甲的严重程度。对指甲进行皮肤镜检查（甲镜检查），记录并分析其特征。
最常见的临床和皮肤镜表现为点状凹陷（86%）和甲剥离（82%）。在甲银屑病的所有皮肤镜特征中，只有纵向条纹和甲下角化过度在中度至重度银屑病患者中显著高于轻度银屑病患者（分别为P = 0.028；P = 0.042）。PASI评分与NAPSI评分呈正相关，但均无显著相关性（r = 0.132，P = 0.360），同样，银屑病病程与皮肤镜下的NAPSI之间也未观察到显著相关性（r = 0.022，P = 0.879）。
皮肤镜可作为早期诊断甲银屑病变化的有用工具，这些变化肉眼不一定总能看到，并且是银屑病或孤立性甲受累时甲变化的一种非侵入性、易于使用的确诊工具。
