The dermoscopic study of nail changes in cases with psoriasis

Introduction: Psoriasis is a chronic, inflammatory, papulosquamous, proliferative condition of the skin. It has a worldwide prevalence of 1-2%. Nail involvement per-se is seen in 5 % of the patients. Nail examination may be done clinically, dermoscopically and by ultrasonography. The purpose of this study is to evaluate the dermoscopic features of nail changes in the cases with psoriasis and to correlate the severity of psoriasis with nail changes.Materials and Methods: A Cross sectional and observational study was undertaken on 104 patients with psoriasis of age more than 12 years (25 female, 79 male). Clinical and dermoscopic (using a video dermatoscope Otiez eScope-DP-M17-filter eScope Pro with magnification from 10X to 200X , 9.0 Mega pixels CMOS sensor and a resolution of 3488X2616 ) nail changes were recorded in all patients. The Nail Psoriasis Severity Index (NAPSI) and Psoriasis Area Severity Index was calculated. Correlation between the two parameters was evaluated. Chi square test was used for statistical analysis.Results: Among the 104 cases, clinical examination revealed pitting (52.88%), onycholysis (42.31%), leukonychia (32.69%), splinter hemorrhages (26.92%), subungual hyperkeratosis (19.23%), crumbling (11.54%), and (10.58%) oil drop sign.Dermoscopic examination of nails showed pitting (54.81%), onycholysis (41.35%) leukonychia (36.54%), splinter hemorrhages (33.65%), subungual hyperkeratosis (21.15%).Conclusion: Dermoscopy aids the diagnosis of nail psoriasis, especially in inconclusive cases where these changes may predate the development of cutaneous plaques.