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 assign a score to each nail for nail bed psoriasis and nail matrix psoriasis by area of involvement in the nail unit.
Nail plate is divided into quadrants by imaginary longitudinal and horizontal lines.
Score is 0 if the findings are not present,
1 if they are present in 1 quadrant of the nail,
2 if present in 2 quadrants,
3 if present in 3 quadrants and 4 if present in 4 quadrants of the nail.
Each nail has a matrix score (0-4) and a nail bed score (0-4),
so the total nail score ranges from 0 to 8.
All patients and healthy control participants underwent a sonographic examination with a high frequency transducer of 22MHz (MyLab-Twice,
Esaote Biomedica,
Genoa,
Italy).
Each nail was scanned with the patient sit and the hands in neutral position over the table.
The ultrasound transducer was gently placed over the nail directed perpendicularly to the surface,
with gel applied over the examined area to provide a correct acoustic interface.
Each nail was scanned in the Grey scale mode and after using Power Doppler.
For each nail we considered the following parameters:
- thickness and status of the of ventral plate
- thickness of the bed nail
- condition of the matrix
- vascularization of the matrix using Power Doppler