Dermatology Online

Nails

Nail Psoriasis Severity Index (NAPSI)

The Nail Psoriasis Severity Index (NAPSI) is used to assign a score to each nail for nail bed and nail matrix psoriasis. The sum of these two scores is the total score for that nail.
Each nail is scored from 0 to 8, providing a comprehensive assessment of nail psoriasis severity.

Nail Matrix Psoriasis consists of any the following: pitting, leukonychia, and red spots in the lunula, and nail plate crumbling.

Score for matrix psoriasis:

0= none
1= present in 1/4 nail
2= present in 2/4
3= present in 3/4
4= present in 4/4

Nail Bed Psoriasis is the presence or absence of any of the following: onycholysis, splinter hemorrhages, oil drop (salmon patch) discoloration and nail bed hyperkeratosis.

Score for nail bed psoriasis:

0= none
1= present in 1/4 nail
2= present in 2/4
3= present in 3/4
4= present in 4/4

Total for nail: (0-8)

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