Supplementary Material for: Comparison of the Objective Severity and the Esthetic Perception of Nail Symptoms in Psoriasis

<b><i>Introduction:</i></b> Nail changes are frequent in psoriasis, and the negative impact of nail psoriasis on patients’ quality of life is well known. No data are available however about the association of the objective severity of nail psoriasis and the subjective perception of these symptoms. The purpose of this study was to determine the correlation between the severity of psoriatic nail changes (as determined by the Nail Psoriasis Severity Index [NAPSI]) and the esthetic assessment of nail psoriasis. <b><i>Methods:</i></b> Participants (general population and psoriasis patients) were asked to rate 19 nail images (including psoriatic and healthy nails) on a 0–10 scale, based on how disturbing they considered them esthetically. Objective severity (NAPSI) scores of nails were compared to the subjective evaluation values. <b><i>Results:</i></b> Nail symptom severity correlated well with the subjective scores. However, while nails with low (0) and high (6–8) NAPSI values received consistent subjective scores, the esthetic perception of nails with moderate NAPSI scores was rather heterogeneous. The age of the respondents showed robust positive correlation with the subjective assessment of nail symptoms both within the psoriatic and the general population. <b><i>Discussion:</i></b> Gender, the presence of psoriasis, or medical education had no significant influence on the esthetic assessment of psoriatic nail changes.

引言：甲改变在银屑病中极为常见，甲银屑病对患者生活质量的负面影响已获广泛证实。然而目前尚无研究探讨甲银屑病客观严重程度与患者对自身症状的主观感知之间的关联。本研究旨在明确甲银屑病皮损严重程度（以甲银屑病严重程度指数[Nail Psoriasis Severity Index, NAPSI]评估）与甲银屑病美学评价之间的相关性。方法：招募普通人群及银屑病患者作为受试者，要求其基于对19张指甲图像（涵盖银屑病甲与健康甲）的美学扰人程度，以0-10分的量表进行评分。将指甲的客观严重程度（NAPSI评分）与受试者的主观评估值进行对比分析。结果：甲症状严重程度与主观评分呈现良好的相关性。不过，尽管NAPSI评分为0与6-8的指甲的主观评分较为一致，但NAPSI评分处于中等水平的指甲，其美学感知则存在显著异质性。在银屑病患者群体与普通人群中，受试者年龄均与甲症状的主观评估呈现显著正相关。讨论：性别、银屑病患病史或医学教育背景，均不会对甲银屑病皮损的美学评估产生显著影响。