Nail psoriasis is usually investigated anddiagnosed by clinical examination. Ultrasonography is anon-invasive imaging technique for studying soft tissueinvolvement. The objective of this study was to estimatenail involvement in patients with chronic plaque psoriasisby ultrasonography. Prevalence, clinical type and severityof nail involvement according to nail psoriasis and severityindex (NAPSI) were investigated in 138 patients withpsoriasis. The thickness of the plate and bed of the fingernailswas measured in 54 patients with psoriasis, 46healthy controls and 37 patients with chronic eczema, usingan ultrasonographic system equipped with a frequencytransducer of 18 MHz. The prevalence of nail psoriasis was73 % (102 out of 138). Onycholysis and thickening of thenail plate were the most common clinical type affecting 56and 50 % of patients, respectively; splinter haemorrhageswas the less common involving 10 % of patients. The meanNAPSI score was 18.4 ± 17.5 (SD; range 0–107). Thethickness of fingernail plate and bed was significantlyhigher in patients with psoriasis with nail disease comparedto healthy controls and patients with chronic eczema(p\0.001). There was a linear correlation between NAPSIand plate and bed nail thickness (r = 0.52 and r = 0.38,p = 0.001). Increased nail plate and bed thickness wasobserved also in patients with psoriasis without clinicallyapparent nail involvement. In conclusion, thickening of thenail is a common feature of nail psoriasis also in patientswithout clinically apparent nail involvement.
Ultrasonography reveals nail thickening in patients with chronic plaque psoriasis.
GISONDI, Paolo;IDOLAZZI, Luca;GIROLOMONI, Giampiero
2012-01-01
Abstract
Nail psoriasis is usually investigated anddiagnosed by clinical examination. Ultrasonography is anon-invasive imaging technique for studying soft tissueinvolvement. The objective of this study was to estimatenail involvement in patients with chronic plaque psoriasisby ultrasonography. Prevalence, clinical type and severityof nail involvement according to nail psoriasis and severityindex (NAPSI) were investigated in 138 patients withpsoriasis. The thickness of the plate and bed of the fingernailswas measured in 54 patients with psoriasis, 46healthy controls and 37 patients with chronic eczema, usingan ultrasonographic system equipped with a frequencytransducer of 18 MHz. The prevalence of nail psoriasis was73 % (102 out of 138). Onycholysis and thickening of thenail plate were the most common clinical type affecting 56and 50 % of patients, respectively; splinter haemorrhageswas the less common involving 10 % of patients. The meanNAPSI score was 18.4 ± 17.5 (SD; range 0–107). Thethickness of fingernail plate and bed was significantlyhigher in patients with psoriasis with nail disease comparedto healthy controls and patients with chronic eczema(p\0.001). There was a linear correlation between NAPSIand plate and bed nail thickness (r = 0.52 and r = 0.38,p = 0.001). Increased nail plate and bed thickness wasobserved also in patients with psoriasis without clinicallyapparent nail involvement. In conclusion, thickening of thenail is a common feature of nail psoriasis also in patientswithout clinically apparent nail involvement.
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