NAIL PSORIASIS: A COMPARATIVE STUDY BETWEEN DERMOSCOPIC AND CLINICAL NAPSI SCORING

Abstract

Objective: To evaluate and compare the effectiveness of dermoscopic Nail Psoriasis Severity Index (DNAPSI) with clinical Nail Psoriasis Severity Index (NAPSI) in detecting early nail changes in patients with psoriasis.

Study Design: Cross-sectional study.

Place and Duration of Study: Conducted at Dermatology department of Ghurki Trust Teaching Hospital, Lahore, Pakistan, from January 2024 to December 2024.

Methodology: A total of 95 patients diagnosed with chronic plaque psoriasis were included. Each patient underwent detailed clinical examination, and NAPSI scores were calculated. Subsequently, dermoscopic evaluation of nails was performed, and DNAPSI scores were recorded. Data were analyzed using SPSS version 27.0. Mean scores were compared, and statistical significance was determined with a p-value ≤0.05.

Results: Dermoscopic examination revealed additional subclinical nail features, including dilated capillaries, longitudinal erythema, and fuzzy lunula, which were not detectable on routine clinical examination. The mean DNAPSI score was significantly higher compared to the clinical NAPSI score (p < 0.05), indicating superior sensitivity of dermoscopy in identifying early and subtle nail changes associated with psoriasis.

Conclusion: Dermoscopy is a more sensitive and effective tool than conventional clinical examination for the assessment of nail psoriasis. Its integration into routine dermatological practice may facilitate early diagnosis, improve disease monitoring, and enhance overall patient management