Utility of dermoscopy in nail psoriasis: Its correlation with the Nail Psoriasis Severity Index (NAPSI) and psoriatic arthritis

Introduction: Nail changes are present in 25-50% of patients with psoriasis with higher frequency in arthritis. Dermoscopy can be a useful tool for better visualization and quantifying the nail defects. Aim of the Study: To evaluate the dermoscopic findings in nail psoriasis. Settings and Design: Hospital based cross sectional descriptive study. Materials and Methods: 110 clinically diagnosed psoriatic fingernails were included in the study. The Nail Psoriasis Severity Index (NAPSI) scores were recorded. Dermoscopic evaluation was conducted and the features were recorded. Comparison of features was done with mild, moderate and high NAPSI groups and arthritic and non-arthritic patients. Statistical analysis included percentages, frequency, chi square test and Fischer’s exact test. Results: The most common dermoscopic findings included subungual hyperkeratosis (90.9%), onycholysis (64.5%) and pitting (62.7%). Pitting, nail plate thickening, transverse grooves, trachyonychia, and onycholysis were associated with higher NAPSI scores (p Conclusion: Dermoscopy coupled with NAPSI scoring in nail psoriasis can serve as a useful guide to assess the nail, cutaneous and arthritic psoriasis. Keywords: Dermoscopy, Nail psoriasis, NAPSI.