Paik Kyungho, Kim Bo Ri, Youn Sang Woong
Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
Ann Dermatol. 2025 Feb;37(1):32-38. doi: 10.5021/ad.24.075.
Although nail psoriasis is a common manifestation among patients with psoriasis, large-scale research exploring the association between nail psoriasis lesions and their intra-nail locations has not been conducted. This study is necessary to elucidate the shared pathophysiology among various phenotypes of nail psoriasis.
We aimed to understand the association between nail psoriasis lesions and analyze their intra-nail locations.
We obtained a total of 5,602 cropped fingernail images from 636 patients with psoriasis. We employed the Computer Vision Annotation Tool to annotate the intra-nail locations of nail psoriasis lesions. We computed χ² statistic to examine the relationship between nail psoriasis lesions and conducted an analysis of their intra-nail locations.
Based on the number of lesions, nail pitting was the most common, followed by leukonychia, with the red spots in the lunula being the rarest. We elucidated the associations between different nail psoriasis lesions, pinpointing a significant association between onycholysis and oil spots (χ² statistic=1,623.88), followed by onycholysis-subungual hyperkeratosis (1,607.50), and subungual hyperkeratosis-oil spots (985.76). A spatial relationship was observed between onycholysis and oil spots, with the intra-nail location of onycholysis being more distal compared to the nearest oil spots. A distribution pattern of nail psoriasis was also demonstrated, where nail matrix lesions were primarily located at the center of the nail, and nail bed lesions were predominantly located near the lateral nail folds.
This study represents a pioneering analysis of the intra-nail location of nail psoriasis lesions, revealing substantial associations and spatial relationships between different lesions.
尽管甲银屑病是银屑病患者的常见表现，但尚未开展大规模研究来探索甲银屑病病变与其甲内位置之间的关联。这项研究对于阐明甲银屑病不同表型之间共同的病理生理学是必要的。
我们旨在了解甲银屑病病变之间的关联，并分析它们在甲内的位置。
我们从636例银屑病患者中总共获得了5602张裁剪后的指甲图像。我们使用计算机视觉标注工具来标注甲银屑病病变的甲内位置。我们计算卡方统计量以检验甲银屑病病变之间的关系，并对它们的甲内位置进行分析。
基于病变数量，甲凹点最为常见，其次是白甲，而甲半月红斑最为罕见。我们阐明了不同甲银屑病病变之间的关联，确定了甲剥离与油滴状斑之间存在显著关联（卡方统计量=1623.88），其次是甲剥离-甲下过度角化（1607.50），以及甲下过度角化-油滴状斑（985.76）。观察到甲剥离与油滴状斑之间存在空间关系，甲剥离在甲内的位置比最近的油滴状斑更靠远端。还展示了甲银屑病的分布模式，其中甲母质病变主要位于指甲中央，而甲床病变主要位于甲褶外侧附近。
本研究是对甲银屑病病变甲内位置的开创性分析，揭示了不同病变之间的大量关联和空间关系。
