Gharaei Nejad Kaveh, Eftekhari Hojat, Rafiei Rana, Darjani Abbas, Alizadeh Narges, Ghadarjani Reyhaneh, Dadgostar Katayoun
Department of Dermatology, Skin Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Department of Pathology, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Heliyon. 2024 Apr 13;10(8):e29608. doi: 10.1016/j.heliyon.2024.e29608. eCollection 2024 Apr 30.
Dermoscopy has emerged as a useful diagnostic tool to evaluate skin lesions, including psoriasis. We aimed to compare the clinical examination and digital dermoscopy findings of nail involvement in patients with psoriatic nails.
This study included 60 patients with clinically diagnosed psoriasis. The nail findings and NAPSI were evaluated clinically and via dermoscopy, and then the severity of the disease was calculated using PASI criteria.
About 32 patients were males, with a median PASI score of 4.4, and pitting and subungual hyperkeratosis were the most common findings. The clinical and dermoscopic examination had a moderate diagnostic resemblance regarding onycholysis, subungual hyperkeratosis, and leukonychia. The resemblance between the two methods for the diagnosis of leukonychia in patients with a duration of disease <2 years (Kappa = 0.59) and 2-6 years was moderate (Kappa = 0.48), and for 6 years< was perfect (Kappa = 0.62). The resemblance for the diagnosis of subungual hyperkeratosis and onycholysis in subjects with a duration of disease <2 years was slight, and for 2-6 years and 6 years< were moderate. The resemblance between the NAPSI score by the two methods was also moderate (95%CI -0.89-0.81, < 0.001).
Dermoscopy is an efficient, supportive, and non-invasive method providing a better diagnosis of nail psoriasis.
皮肤镜已成为评估包括银屑病在内的皮肤病变的有用诊断工具。我们旨在比较银屑病甲患者指甲受累的临床检查和数字皮肤镜检查结果。
本研究纳入60例临床诊断为银屑病的患者。通过临床和皮肤镜检查评估指甲表现和指甲银屑病严重指数（NAPSI），然后使用银屑病面积和严重程度指数（PASI）标准计算疾病严重程度。
约32例为男性，PASI评分中位数为4.4，点状凹陷和甲下过度角化是最常见的表现。临床检查和皮肤镜检查在甲剥离、甲下过度角化和白甲方面具有中等诊断相似性。两种方法对病程<2年患者白甲诊断的相似性为中等（Kappa = 0.59），病程2 - 6年患者为中等（Kappa = 0.48），病程>6年患者为完美（Kappa = 0.62）。病程<2年患者甲下过度角化和甲剥离诊断的相似性轻微，病程2 - 6年和>6年患者为中等。两种方法NAPSI评分的相似性也为中等（95%CI -0.89 - 0.81，P < 0.001）。
皮肤镜是一种有效、辅助且无创的方法，能更好地诊断甲银屑病。
