Model study of dermatoscopic clinical classification of nail psoriasis a based on generalized estimation equation

ZHOU Na-na; WANG Jing-cha; LIU Xue

doi:10.11786/sypfbxzz.1674-1293.20230402

Abstract：Objective To explore the correlation between dermoscopic manifestations of nail psoriasis and clinical classification,and provide a realistic basis for clinical diagnosis and treatment of nail psoriasis.Methods Select a total of 48 patients with nail psoriasis who were treated in our hospital from August 2019 to August 2021 were selected as the nail psoriasis group,and were observed by dermoscopy,and 100 healthy subjects who came to our hospital during the same period were selected as healthy controls group.The general data of the two groups were recorded,including age,gender,history of diabetes,history of hypertension,history of drug allergy,history of smoking,history of drinking,body temperature,course of disease,lesion location,number of lesions and clinical subtypes.Results There was no significant difference in age,gender,history of diabetes,history of hypertension,history of drug allergy,history of smoking,history of drinking,body temperature,BMI,etc.between the two groups(P>0.05).The patients with nail psoriasis were divided according to the characteristics of the dermoscopic image of the diseased nail,and the results were as follows:12 cases of nail plate thickening,8 cases of pitting sign,7 cases of nail peeling,6 cases of oil drop sign,4 cases of splinter hemorrhage,6 cases of nail discoloration,There were 5 cases of nail bed telangiectasia;according to the characteristics of clinical classification,the results were 18 cases of vulgaris type,12 cases of erythrodermic type,11 cases of pustular type,and 7 cases of arthropathy type.The results of dermoscopic diagnosis and clinical classification analysis showed that the thickening of the nail plate, pitting sign, nail peeling, oil drop sign, splinter hemorrhage, nail discoloration, and nail bed telangiectasia were compared in the four clinical classifications. There was statistical significance (P < 0.05). The generalized estimating equation model showed that the change of dermoscopic diagnosis had a significant effect on the change of clinical classification, that is, for each increase or decrease of 1 case of dermoscopic diagnosis, the clinical classification of vulgaris, erythrodermic, pustular, and arthropathy. Correspondingly, the number of cases increased or decreased by 4.986, 3.552, 2.362, and 1.951 cases. Conclusion Dermoscopic features of nail psoriasis include thickening of the nail plate, pitting sign, nail peeling, oil drop sign, splinter hemorrhage, nail discoloration, nail bed telangiectasia, and histopathological types are vulgaris and erythrodermic. The four types of psoriasis, pustular and arthropathy all decreased with the above-mentioned dermoscopic characteristics, which had a good correlation, and the clinical diagnostic efficiency of nail psoriasis could be improved accordingly.