Supplementary Material for: Quadrant‑Based Comparison of UV‑Fluorescence Dermoscopy, Standard Dermoscopy, and Clinical Examination in Adults With Nail Psoriasis: A Prospective Pilot Study of 35 Patients

Background: Accurate visualization of nail‐matrix psoriasis remains challenging. Ultraviolet fluorescence dermoscopy (UVF D) may enhance detection, yet rigorous comparative data are scarce.
Objectives: To compare the diagnostic yield of UVF D with standard dermoscopy and naked eye clinical examination for matrix and bed involvement in nail psoriasis.
Methods: In this single center prospective pilot study (March–July 2024), 35 consecutive adults with plaque psoriasis underwent triplicate assessment (clinical, dermoscopy, UVF D) of all fingernails. Each nail quadrant was scored for matrix NAPSI and bed NAPSI by two blinded dermatologists in randomized order. The study was powered (80 %, α = 0.05) to detect a ≥ 3 point mean difference in matrix NAPSI between modalities.
Results: UVF-D identified matrix involvement in 550/1 400 quadrants (39.3 %) versus 448/1 400 (32.0 %) with standard dermoscopy and 441/1 400 (31.5 %) clinically (p < 0.001; Kendall’s W = 0.42). Mean ± SD matrix-NAPSI scores were 15.7 ± 5.3 (UVF-D), 12.8 ± 5.2 (dermoscopy) and 12.6 ± 4.8 (clinical). Thus, UVF-D detected roughly one additional matrix-affected quadrant for every seven examined and produced a higher matrix-NAPSI, underscoring its added sensitivity over conventional methods.
Limitations: Single-centre pilot (n = 35); consensus scoring precluded formal inter-observer reliability estimates; cross-sectional design prevents evaluation of treatment responsiveness; UVF-D hardware cost and user-training requirements may restrict generalisability.
Conclusions: UVF D significantly improves visualization of nail matrix psoriasis versus standard approaches. Larger multicenter studies should validate its diagnostic and longitudinal utility.

研究背景：精准可视化甲母质银屑病仍存在挑战。紫外线荧光皮肤镜（Ultraviolet Fluorescence Dermoscopy，UVF D）或可提升该病的检出率，但目前相关严格对比研究数据较为匮乏。
研究目的：对比紫外线荧光皮肤镜、常规皮肤镜与裸眼临床检查在评估甲银屑病甲母质与甲床受累情况中的诊断效能。
研究方法：本研究为单中心前瞻性预试验（2024年3月—7月），纳入35例连续入组的斑块状银屑病成人患者，对所有手指甲依次开展临床检查、常规皮肤镜、紫外线荧光皮肤镜三项评估。由2名盲法皮肤科医师按照随机顺序，针对每个指甲象限的甲母质NAPSI与甲床NAPSI进行评分。本研究预设检验效能为80%、检验水准α=0.05，旨在检测不同检查方式间甲母质NAPSI的平均差异≥3分。
研究结果：紫外线荧光皮肤镜在1400个指甲象限中检出550个存在甲母质受累（检出率39.3%），常规皮肤镜检出448个（32.0%），临床裸眼检查检出441个（31.5%），组间差异具有统计学意义（p<0.001；Kendall’s W=0.42）。三种方式对应的甲母质NAPSI评分分别为：紫外线荧光皮肤镜组15.7±5.3，常规皮肤镜组12.8±5.2，临床检查组12.6±4.8。据此，紫外线荧光皮肤镜每检查7个指甲象限即可多检出1个甲母质受累象限，且甲母质NAPSI评分更高，凸显了其相较于传统检查手段的额外灵敏度优势。
研究局限性：本研究为单中心预试验，样本量仅35例；采用共识评分法，无法开展正式的观察者间信度评估；横断面研究设计无法评估治疗反应性；紫外线荧光皮肤镜的硬件成本与操作者培训要求或限制其推广应用。
研究结论：相较于传统检查手段，紫外线荧光皮肤镜可显著提升甲母质银屑病的可视化效果。未来需开展更大样本量的多中心研究，以验证其诊断效能与纵向应用价值。