Youn Sang Woong
Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Ann Dermatol. 2024 Aug;36(4):191-196. doi: 10.5021/ad.24.026.
The nail is an important characteristic in the context of psoriasis. Nail psoriasis exhibits several clinical manifestations. Since the development of the Nail Psoriasis Severity Index (NAPSI) score assessment tool for evaluating the severity of nail psoriasis, nail matrix symptoms such as pitting, leukonychia, crumbling, and red spots have been observed in the lunula. Nail bed symptoms include onycholysis, subungual hyperkeratosis, oil spots, and splinter hemorrhage. However, Beau's lines and nail fold psoriasis, which are not included in this assessment tool, should be considered essential symptoms for indicating the activity of nail psoriasis. Although NAPSI is the most widely used tool for assessing the severity of nail psoriasis, it has uncontrolled limitations. Although other assessment tools have been developed, none have successfully replaced the NAPSI. In clinical trials for nail psoriasis, the NAPSI is used in various forms, such as improvement rates, changes in the mean NAPSI score, and achievement rates of NAPSI 75. Consequently, caution is warranted when interpreting the clinical trial results related to nail psoriasis improvement.
在银屑病的背景下，指甲是一个重要特征。甲银屑病表现出多种临床表现。自从用于评估甲银屑病严重程度的甲银屑病严重程度指数（NAPSI）评分评估工具开发以来，在甲半月区观察到了甲母质症状，如凹点、白甲、甲松脆和红斑。甲床症状包括甲剥离、甲下过度角化、油滴状斑点和裂片形出血。然而，该评估工具未包括的博氏线和甲褶银屑病应被视为指示甲银屑病活动的重要症状。虽然NAPSI是评估甲银屑病严重程度最广泛使用的工具，但它有无法控制的局限性。尽管已经开发了其他评估工具，但没有一个成功取代NAPSI。在甲银屑病的临床试验中，NAPSI以各种形式使用，如改善率、平均NAPSI评分变化和NAPSI 75的达标率。因此，在解释与甲银屑病改善相关的临床试验结果时应谨慎。
