Rich and Scher reported the Nail Psoriasis Severity Index (NAPSI) for evaluating psoriasis involvement of a nail. There are 2 versions - one short and one long. The authors are from Oregon Health Sciences University and Columbia University.
The nail is divided into 4 quadrants (2 proximal, 2 distal).
The presence or absence of 8 features are recorded for each quadrant
The 8 features are:
(1) pitting
(2) leukonychia
(3) red spots in the lunula
(4) crumbling
(5) oil drop (salmon patch dyschroma
(6) onycholysis
(7) subungual hyperkeratosis
(8) splinter hemorrhages
Feature in a Quadrant
Points
absent
0
present
1
Interpretation:
• minimum score: 0
• maximum score: 32
• The higher the score the more extensive the involvement.
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