Comparative study of clinical and dermoscopic features in nail psoriasis

Wanniang, Naphisabet; Navya, Annam; Pai, Varadraj V; Ghodge, Rakhi

doi:10.4103/idoj.idoj_51_19

Cited by 27 publications

(71 citation statements)

References 8 publications

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“…In psoriasis, nail lesions usually manifest 10 years later than skin lesions, and nail involvement is present in 20%-50% of psoriatic patients [18][19][20][21]. According to Polat and Kapicioglu, the most common clinical and dermoscopic findings were pitting and leukonychia [12], and Wanniang et al noted salmon patch (oil drop sign) and splinter hemorrhages significantly better with the dermoscope [22]. In addition to pitting, Yorulmaz and Artuz found salmon patch (oil drop sign) to be associated with higher NAPSI scores [13].…”

Section: Discussionmentioning

confidence: 99%

Study of Nail Psoriasis and Dermoscopic Correlation With Dermoscopic and Modified Dermoscopic Nail Psoriasis Severity Indexes (dNAPSI and dmNAPSI)

Arora

Paul

Kumar

et al. 2022

Dermatol Pract Concept

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Background: Nail involvement in psoriasis may be assessed clinically, ultrasonologically, and dermoscopically. The aim of this study was to assess the dermoscopic features of nails in psoriasis, compare them with clinical findings, and correlate them with the Nail Psoriasis Severity Index (NAPSI) score. Methods: We recruited 120 patients with psoriatic nail changes for the study. The Psoriasis Area Severity Index (PASI) was used to assess the severity of disease. Clinical and dermoscopic (DermLite DL4, ×10, polarized and non-polarized) nail examination determined NAPSI, modified NAPSI (mNAPSI), and NAPSI determined with dermoscopic findings (dermoscopic NAPSI [dNAPSI] and dermoscopic modified NAPSI [dmNAPSI]) were used to assess severity of nail involvement. Results: Subungual hyperkeratosis (50.8%) and nail plate thickening (56.7%) were the commonest clinical nail changes found, and dermoscopically, they were subungual hyperkeratosis and pitting (68.3% each). The average median with interquartile range of PASI and NAPSI scores were 7.5 [5.7-10.8] and 8.0 [6-12], respectively. NAPSI scores increased significantly with the increase in PASI scores (P < 0.001). A comparison of NAPSI and mNAPSI with dNAPSI and dmNAPSI revealed that NAPSI, mNAPSI, and dNAPSI increased significantly with an increase in PASI scores. dNAPSI scores increased significantly with increased mNAPSI and dmNAPSI, and mNAPSI and dmNAPSI were significantly good predictors of joint involvement in psoriasis. Conclusions: Dermoscopy allows for better visualization of nail findings. Evaluating NAPSI and mNAPSI scores in conjunction with dNAPSI and dmNAPSI increases their helps detect early psoriasis, detection of worsening moderate-to-severe psoriasis (PASI >10) and predict joint involvement and their severity

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Section: Discussionmentioning

confidence: 99%

Study of Nail Psoriasis and Dermoscopic Correlation With Dermoscopic and Modified Dermoscopic Nail Psoriasis Severity Indexes (dNAPSI and dmNAPSI)

Arora

Paul

Kumar

et al. 2022

Dermatol Pract Concept

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“…A total of 753 articles were screened and 67 articles included, as depicted in the PRISMA flow diagram in Figure 1 9‐75 . The number of articles per technique varied substantially, ranging from 36 for US to just one on PET/CT.…”

Section: Resultsmentioning

confidence: 99%

Imaging of the nail unit in psoriatic patients:A systematic scoping review of techniques and terminology

Ortner

Mandel

Bertugno

et al. 2022

Experimental Dermatology

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Background The growing interest in the visualization of psoriatic nail unit changes has led to the discovery of an abundance of image characteristics across various modalities. Objective To identify techniques for non‐invasive imaging of nail unit structures in psoriatic patients and review extracted image features to unify the diverse terminology. Methods For this systematic scoping review, we included studies available on PubMed and Embase, independently extracted image characteristics, and semantically grouped the identified features to suggest a preferred terminology for each technique. Results After screening 753 studies, 67 articles on the visualization of clinical and subclinical psoriatic changes in the nail plate, matrix, bed, folds and hyponychium were included. We identified 4 optical and 3 radiological imaging techniques for the assessment of surface (dermoscopy [n = 16], capillaroscopy [n = 12]), sub‐surface (ultrasound imaging [n = 36], optical coherence tomography [n = 4], fluorescence optical imaging [n = 3]), and deep‐seated psoriatic changes (magnetic resonance imaging [n = 2], positron emission tomography‐computed tomography [n = 1]). By condensing 244 image feature descriptions into a glossary of 82 terms, overall redundancy was cut by 66.4% (37.5%–77.1%). More than 75% of these image features provide additional disease‐relevant information that is not captured using conventional clinical assessment scales. Conclusions This review has identified, unified, and contextualized image features and related terminology for non‐invasive imaging of the nail unit in patients with psoriatic conditions. The suggested glossary could facilitate the integrative use of non‐invasive imaging techniques for the detailed examination of psoriatic nail unit structures in research and clinical practice.

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“…The male-to-female ratio was 1.6:1, consistent with Rajsekhar et al .,[ 3 ] whereas Chauhan et al .,[ 4 ] Wanniang et al .,[ 5 ] and Yadav and Khopkar[ 6 ] had a ratio of 2.66:1, 3.1:1, and 2.83:1, respectively. Age group was compatible with Rajsekhar et al .…”

Section: Discussionmentioning

confidence: 99%

“…Most common type of psoriasis was chronic plaque psoriasis in our study, which was compatible with Wanniang et al . 's[ 5 ] findings. Disease type had a significant relation with nail involvement ( P < 0.05), whereas in the study by Kyriakou et al .…”

Section: Discussionmentioning

confidence: 99%

Study of Clinical and Dermoscopic Features in Nails of Papulosquamous Disorders and their Correlation with Disease Severity

Subudhi

Jena

Mohanty

et al. 2022

Indian Journal of Dermatology

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Background: As face is the index of the mind, so is the nail the index to health, as the nail is capable of mounting only a limited number of reaction patterns to the large number of disorders affecting it. Dermoscopy is thus a valuable aid not only in enhancing visible nail features but also in revealing cryptic features of diagnostic value. Aims: To study the clinical and dermoscopic features in nails of papulosquamous disorders and correlate it with disease severity. Methods and Material: This was a cross-sectional study with convenient sampling. After obtaining ethical clearance, according to inclusion and exclusion criteria, papulosquamous disorders were enrolled in the study. Finger nails and toe nails were numbered 1–10. Detailed clinical examination was done. Wet and dry dermoscopic examination was made in both polarised and non-polarised mode using ultrasound (USG) gel. Psoriasis area and severity index (PASI) and body surface area (BSA) were compared with nail changes. Statistical analysis of data was performed using the Statistical Package for the Social Sciences (SPSS) version 26. Results: Out of 203 patients, 117 were male. Psoriasis was the most common disease (55.6%). A total of 65.51% of patients had nail changes. Pitting was the most common finding in psoriasis, both dermoscopically and clinically. Splinter haemorrhage, oil drop, dilated capillaries, and pseudofibre sign were detected better on dermoscopy (P < 0.05). Positive correlation was found between PASI and nail psoriasis severity index (NAPSI). A strong correlation was also found between clinical (cNAPSI) and dermoscopic (dNAPSI). Thinning was the most common in lichen planus. No relation between BSA and nail changes was observed. Conclusions: Dermoscopy is thus a valuable aid not only in enhancing visible nail features but also in revealing cryptic features of diagnostic value and reducing the requirement for invasive procedures like nail biopsies, early diagnosis, directing management.

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Comparative study of clinical and dermoscopic features in nail psoriasis

Cited by 27 publications

References 8 publications

Study of Nail Psoriasis and Dermoscopic Correlation With Dermoscopic and Modified Dermoscopic Nail Psoriasis Severity Indexes (dNAPSI and dmNAPSI)

Study of Nail Psoriasis and Dermoscopic Correlation With Dermoscopic and Modified Dermoscopic Nail Psoriasis Severity Indexes (dNAPSI and dmNAPSI)

Imaging of the nail unit in psoriatic patients:A systematic scoping review of techniques and terminology

Study of Clinical and Dermoscopic Features in Nails of Papulosquamous Disorders and their Correlation with Disease Severity

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