The following study is a case control study to compare the clinical and dermoscopic nail changes in 45 patients with psoriasis with 45 age and sex matched healthy individuals; and to study their correlation with the NAPSI score.

Psoriasis is a chronic inflammatory disorder of the skin, of multifactorial pathogenesis characterized by altered epidermal growth and differentiation. It affects 1-3% of the world’s population. Nails are commonly affected in upto 50 percent of patients with psoriasis and in upto 80 percent of patients with psoriatic arthritis. Several distinct changes such as pitting, onycholysis, salmon patches, hemorrhages and subungual hyperkeratosis are seen in the nail plate and indicate severe cutaneous psoriasis and are also closely associated with joint inflammation. However, by the time these changes are detected grossly, the nail would have been severely damaged, affecting the day to day life of the individual.

Dermoscopy is a noninvasive technique which is commonly used to obtain a rapid and magnified in vivo observation of the nail with better visualization of abnormalities in the hyponychium and proximal nail fold. It may help in the diagnosis of nail psoriasis in inconclusive cases and improve the follow-up of the patient with respect to his/her response to treatment.

NAPSI and modified NAPSI scoring systems are commonly used to assess the extent and severity of psoriatic nail changes. They also show a significant correlation with psoriatic arthritis.Very few studies have been done to detect nail changes and calculate NAPSI scores using dermoscopy.