The dermoscopic features of nail psoriasis and the relationship with disease severity

Psoriatic nail changes differ depending on nail bed or nail plate involvement. There are only few studies which these changes are evaluated dermoscopically. We aimed to detect frequence of dermoscopic signs, compare clinical examination and dermoscopic evaluation and inquire the relationship between severity indicators. Who were admitted to İnonu University Faculty of Medicine Dermatology Clinic at the time range between 1.12.2013- 1.06.2014 are involved in study. Their ages varied from 18 to 65. Severity of disease is determined by calculating PASI and similarly severity of nail involvement is determined by NAPSI. Nails of the patients are examined clinically and monitorized by a videodermoscopy. There were 17 (%42,5) men and 23(%57,5) women. Mean age was 34,05 ± 15,90. PASI score was significantly higher in men than in women statistically. When the most encountered lesion on clinical examination was pitting, it was leukonychia on dermoscopical assesment. There was no significant difference between clinically calculated NAPSI and dermoscopically calculated NAPSI. Clinical PASI, NAPSI and dermoscopic NAPSI scores weren't significantly relevant. Dilateded and elongated capillaries are detected on nail bed by dermoscopy but this finding wasn't related to the disease severity. PASI score was statistically higher in smoking patients, but NAPSI score wasn't affected.As a result, by the dermoscopy method, early diagnosis of minimal onycholysis, evaluation of lineer erythematous side in clinically indistinguishable onycholysis cases, imaging of pittings those can not be seen clinically because of exogenous pigmentation, some oil stain and leuconychia cases those can not be seen naked eyes, have been provided. We think that, dermoscopy can be preferred as a supportive and noninvasive diagnostic tool when nail psoriasis diagnosis is suspicious clinically. Keywords: Psoriasis, PASI, NAPSI, Dermoscopy