The Nail Psoriasis Severity Index (NAPSI) is a valuable physician-administered tool used to evaluate the severity of nail psoriasis, which can significantly affect patients’ quality of life. Nail involvement in psoriasis is common and can present unique treatment challenges. The NAPSI helps clinicians assess the extent and severity of nail psoriasis and monitor the effectiveness of treatment over time.
The NAPSI scoring system evaluates the nail matrix and nail bed separately for each fingernail, focusing on characteristic features such as pitting, leukonychia, crumbling, and red spots in the lunula for the matrix, and onycholysis, splinter hemorrhages, subungual hyperkeratosis, and oil drop (salmon patch) discoloration for the nail bed. Each nail is scored from 0 to 8, providing a comprehensive assessment of nail psoriasis severity.
Assessment of Nail Psoriasis:
Each characteristic is scored based on presence or absence, with higher scores indicating more severe nail psoriasis.
Reference
Nail Psoriasis Severity Index: A Useful Tool for Evaluation of Nail Psoriasis. Rich P, Scher RK. J Am Acad Dermatol. 2003 Aug;49(2):206-12. doi: 10.1067/s0190-9622(03)00910-1. PMID: 12894066.
How can clinicians navigate emotionally complex patient interactions while maintaining empathy and trust? In this article, Mio Nakamura discusses communication approaches that may help strengthen patient relationships in dermatology settings.
Read summaries from the IPC symposium at the 2026 Society for Investigative Dermatology (SID) Annual Meeting covering disease modification, immune pathways, therapeutic escape, and psoriasis treatment response.
In this Take Ten with IPC video, Professor Peter van de Kerkhof discusses the use and misuse of systemic corticosteroids in psoriasis. He questions whether they contraindicate the treatment of psoriasis, while also covering his personal experience in prescribing them.
In this Take Ten with IPC video, Professor Peter van de Kerkhof discusses the use and misuse of topical corticosteroids in psoriasis, covering current use, guidelines, and consequences.
Missed the joint symposium hosted by the International Eczema Council (IEC) and International Psoriasis Council (IPC) at the American Academy of Dermatology (AAD) Annual Meeting? Select presentations from Psoriasis or Dermatitis? When Boundaries Blur and Treatments Flip the Script are now available, covering diagnostic overlap, emerging tools, treatment-related reactions, and practical strategies for managing complex cases across diverse patient populations.
