Rev. Esp. Pod. 2023; 34(2): 113-120 / DOI: 10.20986/revesppod.2023.1667/2023
Sandra Sánchez-Morilla, Ana Belén Ortega-Ávila, José Alberto Sánchez-Castillo
ABSTRACT
The nail system forms a complex anatomical unit fundamental in humans, susceptible to numerous alterations due to both systemic and local pathological processes. The study of nail pathology is a subject of special interest, however, in the clinical setting, it is still difficult to analyse parameters such as specific area of extension, anatomy involved or percentage of involvement, making it difficult to carry out an objective assessment and establish effective treatment guidelines, having to resort, on numerous occasions, to histopathological examination. In this sense, measurement indices are positioned as a measurement tool that would allow these factors to be assessed in a numerical, reproducible and simple way. The aim of this study was to identify measurement tools for the different nail pathologies described in the literature. A peer-review of the literature was conducted in four databases according to Critical Appraisal Skills Programme España (CASPe) criteria. The findings described the existence of 12 nail pathology measurement tools. Conclusions finally pointed out the Nail Psoriasis Severity Index or NAPSI index as the most widely used method to asses the severity of nail psoriasis, despite reports of subsequent modifications. For onychomycosis, the Scoring Clinical Index for Onychomycosis or SCIO index appeared to be the most useful objective method in clinical practice. For chronic paronychia, the Chronic Paronychia Index standed out as a good alternative to previous assessment options.
RESUMEN
El sistema ungueal conforma una compleja unidad anatómica fundamental en el ser humano, susceptible de sufrir numerosas alteraciones debido a procesos patológicos, tanto sistémicos como locales. El estudio de la patología ungueal es un tema de especial interés, sin embargo, en el ámbito clínico todavía resulta complicado analizar parámetros como área concreta de extensión, anatomía comprometida o porcentaje de afectación, dificultando poder realizar una valoración objetiva y establecer pautas efectivas de tratamiento, debiendo recurrir, en numerosas ocasiones, al examen histopatológico. En este sentido, los índices de medición se posicionan como una herramienta que permitiría valorar estos factores de forma numérica, reproducible y simple. El objetivo de este estudio fue identificar las herramientas de medición de las diferentes patologías ungueales descritas en la literatura. Se realizó una revisión de la literatura por pares en cuatro bases de datos atendiendo a criterios del Critical Appraisal Skills Programme España (CASPe). Los hallazgos describieron la existencia de 12 herramientas de medición de patología ungueal. Las conclusiones señalaron, finalmente, el Nail Psoriasis Severity Index o índice NAPSI como método más utilizado para valorar la severidad de la psoriasis ungueal, pese a los reportes obtenidos en sus modificaciones posteriores. En cuanto a la onicomicosis, el Scoring Clinical Index for Onychomycosis o índice SCIO resultó ser el método objetivo más útil en la práctica clínica. Para la paroniquia crónica, el Índice de paroniquia crónica se distinguió como una buena alternativa a las opciones de valoración previas.
New comment
Comments
No comments in this article
References
1. Haneke E. Anatomy of the nail unit and the nail biopsy. Semin Cutan Med Surg. 2015;34(2):95-100.
2. Gupta AK, Tosti A. Nails and the clinician. Clin Dermatol. 2013;31(5):507-8.
3. Haneke E. Important malignant and new nail tumors. J Dtsch Dermatol Ges. 2017;15(4):367-86.
4. Wollina U, Nenoff P, Haroske G, Haenssle HA. The Diagnosis and Treatment of Nail Disorders. Dtsch Arztebl Int. 2016;113(29-30):509-18.
5. Gregoriou S, Argyriou G, Larios G, Rigopoulos D. Nail disorders and systemic disease: what the nails tell us. J Fam Pract. 2008;57(8):509-14.
6. Petraškienė R, Valiukevičienė S, Macijauskienė J. Associations of the quality of life and psychoemotional state with sociodemographic factors in patients with psoriasis. Medicina (Kaunas). 2016;52(4):238-43.
7. Rani SU, T Haritha, Rao TS, Rao RS. Study of Nail Disorders in Dermatology Int J.Contemp Med Res 2020. IJCMR;6(1).
8. Lipner SR, Scher RK. Onychomycosis: Clinical overview and diagnosis. J Am Acad Dermatol. 2019;80(4):835-51.
9. Milobratović D, Janković S, Vukičević J, Marinković J, Janković J, Railić Z. Quality of life in patients with toenail onychomycosis. Mycoses. 2013;56(5):543-51.
10. Canedo ED, Valença KS, Santos GA. An analysis of measurement and metrics tools: A systematic literature review. Proc Annu Hawaii Int Conf Syst Sci. 2019;2019:6970-80.
11. Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-44.
12. Cabello JB. por CASPe. Plantilla para ayudarte a entender una Revisión Sistemática. En: CASPe. Guías CASPe de Lectura Crítica de la Literatura Médica. Alicante: CASPe; 2005. Cuaderno I. p.13-17.
13. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
14. Warshaw EM, Traywick CA, Hoffman AA, Lilly KK, Koshnick RL, Robinson JW, et al. Naildex: pilot evaluation of an onychodystrophy severity instrument. Mycoses. 2008;51(1):14-20.
15. Carney C, Tosti A, Daniel R, Scher R, Rich P, DeCoster J, et al. A new classification system for grading the severity of onychomycosis: Onychomycosis Severity Index. Arch Dermatol. 2011;147(11):1277-82.
16. Sergeev AY, Gupta AK, Sergeev YV. The Scoring Clinical Index for Onychomycosis (SCIO index). Skin Therapy Lett. 2002;7(Suppl 1):6-7.
17. Tavakkol A, Pollak R, Harkless L, Shebetka KA, Weisfeld M, Kianifard F, et al. Toenail assessment tool for quantitation of visibly infected mycotic nail plate in onychomycosis. Cutis. 2007;80(6):488-94.
18. Rich P, Scher RK. Nail Psoriasis Severity Index: a useful tool for evaluation of nail psoriasis. J Am Acad Dermatol. 2003;49(2):206-12.
19. Aktan S, Ilknur T, Akin C, Ozkan S. Interobserver reliability of the Nail Psoriasis Severity Index. Clin Exp Dermatol. 2007;32(2):141-4.
20. Lubrano E, Scrivo R, Cantini F, Marchesoni A, Mathieu A, Olivieri I, et al. Is the Nail Psoriasis Severity Index reliable in the assessment of nail psoriasis by rheumatologists? Arthritis Care Res (Hoboken). 2012;64(3):455-8.
21. Kaçar N, Ergin S, Erdoğan BS. The comparison of Nail Psoriasis Severity Index with a less time-consuming qualitative system. J Eur Acad Dermatol Venereol. 2008;22(2):219-22.
22. Parrish CA, Sobera JO, Elewski BE. Modification of the Nail Psoriasis Severity Index. J Am Acad Dermatol. 2005;53(4):745-6.
23. Cassell SE, Bieber JD, Rich P, Tutuncu ZN, Lee SJ, Kalunian KC, et al. The modified Nail Psoriasis Severity Index: validation of an instrument to assess psoriatic nail involvement in patients with psoriatic arthritis. J Rheumatol. 2007;34(1):123-9.
24. de Jong EM, Menke HE, van Praag MC, van De Kerkhof PC. Dystrophic psoriatic fingernails treated with 1% 5-fluorouracil in a nail penetration-enhancing vehicle: a double-blind study. Dermatology. 1999;199(4):313-8.
25. Augustin M, Blome C, Costanzo A, Dauden E, Ferrandiz C, Girolomoni G, et al. Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA): development and validation of a tool for assessment of nail psoriasis outcomes. Br J Dermatol. 2014;170(3):591-8.
26. Klaassen KM, van de Kerkhof PC, Bastiaens MT, Plusjé LG, Baran RL, Pasch MC. Scoring nail psoriasis. J Am Acad Dermatol. 2014;70(6):1061-6.
27. Atış G, Göktay F, Altan Ferhatoğlu Z, Kaynak E, Sevim Keçici A, Yaşar Ş, et al. A Proposal for a New Severity Index for the Evaluation of Chronic Paronychia. Skin Appendage Disord. 2018;5(1):32-37.
28. Cannavò SP, Guarneri F, Vaccaro M, Borgia F, Guarneri B. Treatment of psoriatic nails with topical cyclosporin: a prospective, randomized placebo-controlled study. Dermatology. 2003;206(2):153-6.
29. Rich P, Scher RK. Nail Psoriasis Severity Index: a useful tool for evaluation of nail psoriasis. J Am Acad Dermatol. 2003;49(2):206-12.
30. Dubljanin E, Dzamic A, Vujcic I, Mijatovic S, Crvenkov T, Grujicic SS, et al. Correlation of clinical characteristics, by calculation of SCIO index, with the laboratory diagnosis of onychomycosis. Braz J Microbiol. 2022;53(1):221-9.
31. Daniel CR 3rd, Iorizzo M, Piraccini BM, Tosti A. Grading simple chronic paronychia and onycholysis. Int J Dermatol. 2006;45(12):1447-8.