Aims and objectives
Psoriasis is one of the most common immune-mediated inflammatory and chronic skin diseases that affects approximately 1-3% of the population.
Nails can be affected in 15–50 % of patients with psoriasis.
The aim of this study was to show the potential of the latest sonographic equipment using high-frequency probes in depicting nail changes in patient with psoriatic onychopathy.
Methods and materials
From March 2016 to July 2016,
17 patient with diagnosis of psoriasis and 10 healthy control participants were enrolled in the study.
17 patients (range 25-81 y.o) (10F,
7M),
from the Dermatology Section of the University Hospital “San Martino” of Genoa,
and 10 healthy control participants (5F,5M) (range 26- 66 years y.o).
For both groups,
for each nail,
we calculated a clinic score: NAPSI (Nail Psoriasis Severity Index).
NAPSI is a numeric,
reproducible,
objective,
simple tool for evaluation of nail psoriasis.
It is used to...
Results
In 170 nails of patients with psoriasis,
65 nails had NAPSI score>0 (clinically evident) and 105 (clinically healthy) nails had NAPSI score =0.
Nails of healthy controls (Fig.1) 7 had decreased thickness of ventral plate with no deformities (7%),
20 (20%) had increased thickness of the nail bed,
3 had alteration of matrix (3%),
6 (6%) had increased vascularization signal.
Nails with NAPSI >0 (Fig.2) 46 had decreased thickness of ventral plate with deformation (70,7%),
36 had increased thickness of the nail bed (55,4%),
19...
Conclusion
The use of a high resolution/frequency probe allows for precise and detailed analysis of diseased nail structures,
which are non-discernible to the naked eye.
Given this outcome,
it may help the assistant physician not only in the diagnosis but also in managing the patient.
Nevertheless,
further studies are required to establish if the presence of nail vascularization in normal-appearing nails of psoriatic patients is an early sign of onychopathy.
Personal information
Ilaria Mussetto - University of Genoa - Scuola di Specializzazione in Radiodiagnostica
Nicola Romano - University of Genoa - Scuola di Specializzazione in Radiodiagnostica
Aldo Fischetti - University of Genoa - Scuola di Specializzazione in Radiodiagnostica
Alessandro Muda - Hospital “IRCSS San Martino - IST” of Genoa
References
1) Gisondi P,
Idolazzi L,
Girolomoni.
“Ultrasonography reveals nail thickening in patient with chronic plaque psoriasis”.
2012 Arch Dermatol Res.
2) Guiterrez M,
Filippucci E,
et al.
“Subclinical entheseal involvement in patient with psoriasis: an ultrasound study”.
2011 Semin Arthritis Rheum.
3) Sandobal C,
Carbo E,
Iribas J,
et al.
“ Ultrasound nail imaging on patients with psoriasis and psoriatic arthritis compared with rheumatoid arthritis and control subjects.” 2014 J Clin Rheumatol.
4) Ash ZR,
Tinazzi I,
Galleo CC,
et al.
“Psoriasis patient with nail...