Van de Kerkhof et al developed a grading system for patients with the Brittle Nail Syndrome (BNS). This can help monitor a patient over time and to evaluate the effectiveness of interventions. The authors are from University Medical Centre St Radboud Nijmegen (The Netherlands), Columbia University, the University of Hamburg, Justus Liebig University in Glessen (Germany) and the University of Washington in Seattle.
Parameters graded:
(1) lamellar splitting
(2) transverse (horizontal) splitting of distal nail plate
(3) ridging and longitudinal grooves
(4) longitudinal splitting
(5) nail thickening
(6) nail thinning
|
Parameter |
Finding |
Grade |
|
lamellar splitting |
none |
0 |
|
|
mild (distal furrows not involving the entire free edge of the nail plate) |
1 |
|
|
moderate (distal furrows involving the complete free edge of the nail plate) |
2 |
|
|
severe (complete free edge of the nail plate involved, covering at least one third of the nail plate) |
3 |
|
transverse splitting |
none |
0 |
|
|
mild (1 superficial) |
1 |
|
|
moderate (2 or 3) |
2 |
|
|
severe (multiple with loosening of at least a third of the distal nail plate) |
3 |
|
ridging |
none |
0 |
|
|
mild (few superficial) |
1 |
|
|
moderate (few deep) |
2 |
|
|
severe (> 70% of plate with deep grooves) |
3 |
|
longitudinal splitting |
none |
0 |
|
|
mild (1 superficial) |
1 |
|
|
moderate (1 or 2 deep) |
2 |
|
|
severe (multiple superficial and/or deep) |
3 |
|
nail thickening or thinning |
none (normal thickness) |
0 |
|
|
mild |
1 |
|
|
moderate (definite change) |
2 |
|
|
severe (>= 2 times or <= 0..5 times normal) |
3 |
Specialty: Dermatology
