NAPSI utilization as an evaluation method of nail psoriasis in patients using acitretin

Mukai, Maira Mitsue; Poffo, Isabela Fleischfresser; Werner, Betina; Brenner, Fabiane Mulinari; Filho, José Hermênio Cavalcante Lima

doi:10.1590/s0365-05962012000200010

Cited by 18 publications

(13 citation statements)

References 10 publications

(4 reference statements)

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“…43 Conversely, a Brazilian study conducted on 20 patients found no significant improvements after a four-month treatment course. 44 However, it is important to note that acitretin may cause adverse effects such as nail thinning, which may impact areas of the nail plate which have normal thickness. 8 …”

Section: Treatmentmentioning

confidence: 99%

Nail psoriasis: a review of the literature

Schons

Knob

Murussi

et al. 2014

An. Bras. Dermatol.

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Nails are considered epidermal appendages, and as such, are commonly affected in patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result of their condition. Two patterns of nail disorders have been shown to be caused by psoriasis. Nail matrix involvement can result in features such as leukonychia, pitting (punctures or cupuliform depressions), red spots in the lunula and crumbling. Nail bed involvement, on the other hand, can cause onycholysis, salmon or oil-drop patches, subungual hyperkeratosis and splinter hemorrhages. Nail disease causes aesthetic and functional impairment, and is indicative of more severe forms of psoriasis as well as of joint involvement. The treatment for nail psoriasis involves behavioral interventions, topical medications, or systemic therapy in case of extensive skin or joint involvement. This article presents a review of the main features of nail psoriasis, its clinical presentation, diagnostic and assessment methods, clinical repercussions, and of its available treatment options.

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Section: Treatmentmentioning

confidence: 99%

Nail psoriasis: a review of the literature

Schons

Knob

Murussi

et al. 2014

An. Bras. Dermatol.

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“…Improvement was measured using the Nail Psoriasis Severity Index (NAPSI) score and the modified NAPSI score. The NAPSI score, proved to be an effective tool in quantifying changes in the nail, evaluates the presence or absence of lesions such as salmon patches, onycholysis, nail bed hyperkeratosis, pitting, leukonychia, and crumbling . The modified NAPSI score is a measure of severity of nail matrix and nail bed psoriasis on each nail quadrant.…”

Section: Effectivenessmentioning

confidence: 99%

Acitretin

2013

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Acitretin, a synthetic retinoid, is the pharmacologically active metabolite of etretinate. It is currently approved by the US Food and Drug Administration for the treatment of severe psoriasis in adults and has been established as a second-line therapy for the treatment of psoriasis resistant to the use of topical therapy. It is also an option for generalized pustular psoriasis, palmoplantar pustulosis, exfoliative erythrodermic psoriasis, and severe psoriasis in the setting of acitretin. It also has been shown to have chemo-preventative characteristics. Acitretin is limited by its teratogenicity and therefore considered inappropriate in most female patients of childbearing age. Common side effects include mucocutaneous dryness and elevated triglycerides.

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“…NAPSI scoring system has some limitations, as it does not specifically consider the severity of nail matrix or nail bed involvement. In a recent report by Mukai et al [14], NAPSI scores were evaluated in psoriatic patients using acitretin, and it was concluded that the method was easy and rapid in measuring the improvement of the treatment; however, it did not quantify the existing lesions and might not detect small changes. In 2007, a modified NAPSI (mNAPSI) was proposed by Cassell et al [15] in order to increase the sensitivity of NAPSI, using a qualitative gradation of severity for each parameter from 0 to 3 in each quadrant.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Nail Psoriasis: Common Concepts and New Trends

Oram

Akkaya

2013

Dermatology Research and Practice

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The lifetime incidence of nail involvement in psoriatic patients is estimated to be 80–90%, and the nails can be affected in 10% to 55% of psoriatic patients. Psoriasis may also solely involve the nails, without any other skin findings, in which the treatment can be more challenging. Nail psoriasis may lead to considerable impairment in quality of life due to aesthetic concerns and more importantly limitations in daily activities resulting from the associated pain, which may be overlooked by the physicians. Several topical and systemic treatment modalities, as well as radiation and light systems, have been used in the treatment of nail psoriasis. In the last decade, the introduction of biologic agents and the utilization of laser systems have brought a new insight into the treatment of nail psoriasis. This paper focuses on the recent advances, as well as the conventional methods, in treating nail psoriasis in adults and children, in reference to an extensive literature search.

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NAPSI utilization as an evaluation method of nail psoriasis in patients using acitretin

Abstract: The method was easy and of rapid execution while potentially bringing information about changes in nail plate and matrix during treatment. The Nail Psoriasis Severity Index does not quantify the existing lesions and might not have the sensitivity to detect small changes.

Cited by 18 publications

References 10 publications

Nail psoriasis: a review of the literature

Nail psoriasis: a review of the literature

Acitretin

Treatment of Nail Psoriasis: Common Concepts and New Trends

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