title: Patterns of clinical nail appearances in patients with cutaneous psoriasis.
abstract: OBJECTIVE
  Nail manifestations are often an overlooked aspect in psoriatic disease, cutaneous and joint involvement being far more often reported and investigated. The reported prevalence of nail changes varies in literature, specific fingernail clinical features having different degrees of occurrence. The aim of this study was to describe specific clinical patterns of fingernail alterations in adult patients with plaque-type psoriasis in a university hospital in the North-West of Romania.
  
  
  METHODS
  Clinical data of 35 patients with fingernail psoriasis were collected and analyzed. Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores were used to quantify disease extension in each patient.
  
  
  RESULTS
  PASI score proved linearly correlated with NAPSI score (p<0.05). The age of onset of fingernail psoriasis was positively correlated with age of onset cutaneous psoriasis (p<0.0001). Furthermore, the duration of cutaneous involvement and NAPSI proved significantly related (p<0.05). The third fingernail in the right hand and first fingernail in the left hand were in most of the cases severely affected. The most common observed nail pattern was pitting, followed by salmon patches and subungual hyperkeratosis.
  
  
  CONCLUSIONS
  Important nail changes appear even in moderate forms of cutaneous psoriasis. Particular localization of specific fingernail psoriasis pattern enables the possibility of detecting early stage disease.
authors.affiliation: Histology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Elena Mihaela
authors.initials: EM
authors.lastname: Marina
authors.affiliation: Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Carolina
authors.initials: C
authors.lastname: Botar-Jid
authors.affiliation: Medical Informatics and Biostatistics Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Sorana Daniela
authors.initials: SD
authors.lastname: Bolboaca
authors.affiliation: Physiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Iulia Ioana
authors.initials: II
authors.lastname: Roman
authors.affiliation: Dermatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Corina Simona
authors.initials: CS
authors.lastname: Senila
authors.affiliation: Histology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Carmen Mihaela
authors.initials: CM
authors.lastname: Mihu
authors.affiliation: Dermatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dumitru Alexandru
authors.initials: DA
authors.lastname: Tataru
keywords: NAPSI; nail pattern; psoriasis vulgaris