Background: The response to treatment in patients suffering from skin and nail psoriasis is quantitatively evaluated by monitoring clinical severity and quality of life indexes, especially in the context of clinical trials. Among them, the psoriasis area severity index (PASI), the nail psoriasis area severity index (NAPSI), and the dermatology life quality index (DLQI) are currently the most widely used indexes. Objective: To study the short-term correlation between PASI, NAPSI, and DLQI in patients with skin and nail psoriasis at baseline and 3 months after treatment initiation. Materials and Methods: This is a 2-center prospective, observational, cross-sectional study of 40 treatment-naive patients suffering from chronic plaque psoriasis with nail involvement and requiring systemic therapy. Disease activity and quality of life were assessed at baseline and 3 months after treatment initiation by measuring PASI, NAPSI, and DLQI scores. Statistical correlations between theses indexes were investigated using the appropriate statistical tests. Results: A positive, strong correlation was observed between DLQI and NAPSI at baseline (r = 0.579, p <0.001) and at 3 months (r = 0.484, p = 0.002). Similarly, a strong correlation was noted between DLQI and PASI at baseline (r = 0.496, p = 0.001) and at 3 months (r = 0.401, p = 0.01). Moreover, we observed a positive strong correlation (r = 0.515, p = 0.001) between DLQI at baseline and NAPSI at 3 months and a moderate correlation (r = 0.433, p = 0.005) between DLQI at baseline and PASI at 3 months. Conclusion: The observed positive correlations between PASI, NAPSI, and DLQI provide further evidence in support of their simultaneous utilization in clinical studies for skin and nail psoriasis. Moreover, the predictive value of DLQI at baseline emphasizes the importance of quality of life assessment when designing a therapeutic study as well as in the everyday clinical practice.

1.
Naldi
L
,
Svensson
A
,
Diepgen
T
,
Elsner
P
,
Grob
JJ
,
Coenraads
PJ
, et al.;
European Dermato-Epidemiology Network
.
Randomized clinical trials for psoriasis 1977-2000: the EDEN survey
.
J Invest Dermatol
.
2003
May
;
120
(
5
):
738
41
.
[PubMed]
0022-202X
2.
Paul
C
,
Gourraud
PA
,
Bronsard
V
,
Prey
S
,
Puzenat
E
,
Aractingi
S
, et al.
Evidence-based recommendations to assess psoriasis severity: systematic literature review and expert opinion of a panel of dermatologists
.
J Eur Acad Dermatol Venereol
.
2010
Apr
;
24
Suppl 2
:
2
9
.
[PubMed]
0926-9959
3.
de Vries
AC
,
Bogaards
NA
,
Hooft
L
,
Velema
M
,
Pasch
M
,
Lebwohl
M
, et al.
Interventions for nail psoriasis
.
Cochrane Database Syst Rev
.
2013
Jan
;(
1
):
CD007633
.
[PubMed]
1469-493X
4.
Finlay
AY
,
Khan
GK
.
Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use
.
Clin Exp Dermatol
.
1994
May
;
19
(
3
):
210
6
.
[PubMed]
0307-6938
5.
de Berker
DA
,
Baran
R
,
Dawber
RP
. The nail in dermatological diseases. In:
Baran
R
,
Dawber
RP
,
de Berker
DA
,
Haneke
E
,
Tosti
A
, editors
.
Baran and Dawber’s diseases of the nails and their management
. 3rd ed.
Malden
:
Blackwell Science
;
2001
. pp.
172
222
.
6.
Baran
R
.
The burden of nail psoriasis: an introduction
.
Dermatology
.
2010
;
221
Suppl 1
:
1
5
.
[PubMed]
1018-8665
7.
Kyriakou
A
,
Patsatsi
A
,
Sotiriadis
D
.
The agreement among the different ways of measuring NAPSI and their correlation with DLQI
.
J Dtsch Dermatol Ges
.
2014
Nov
;
12
(
11
):
1051
3
.
[PubMed]
1610-0379
8.
Hallaji
Z
,
Badaeijndaghi
F
,
Akbarzadeh
M
,
Seyedi
SZ
,
Barzegari
M
,
Noormohammadpour
P
, et al.
A significant association exists between the severity of nail and skin involvement in psoriasis J Am Acad Dermatol
.
2012
Jan;66(1): e 12-3
9.
Rich
P
,
Griffiths
CE
,
Reich
K
,
Nestle
FO
,
Scher
RK
,
Li
S
, et al.
Baseline nail disease in patients with moderate to severe psoriasis and response to treatment with infliximab during 1 year
.
J Am Acad Dermatol
.
2008
Feb
;
58
(
2
):
224
31
.
[PubMed]
0190-9622
10.
de Jong
EM
,
Seegers
BA
,
Gulinck
MK
,
Boezeman
JB
,
van de Kerkhof
PC
.
Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients
.
Dermatology
.
1996
;
193
(
4
):
300
3
.
[PubMed]
1018-8665
11.
Augustin
M
,
Krüger
K
,
Radtke
MA
,
Schwippl
I
,
Reich
K
.
Disease severity, quality of life and health care in plaque-type psoriasis: a multicenter cross-sectional study in Germany
.
Dermatology
.
2008
;
216
(
4
):
366
72
.
[PubMed]
1018-8665
12.
Schäfer
I
,
Hacker
J
,
Rustenbach
SJ
,
Radtke
M
,
Franzke
N
,
Augustin
M
.
Concordance of the Psoriasis Area and Severity Index (PASI) and patient-reported outcomes in psoriasis treatment
.
Eur J Dermatol
.
2010
Jan-Feb
;
20
(
1
):
62
7
.
[PubMed]
1167-1122
13.
Mattei
PL
,
Corey
KC
,
Kimball
AB
.
Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI): the correlation between disease severity and psychological burden in patients treated with biological therapies
.
J Eur Acad Dermatol Venereol
.
2014
Mar
;
28
(
3
):
333
7
.
[PubMed]
0926-9959
14.
Hesselvig
JH
,
Egeberg
A
,
Loft
ND
,
Zachariae
C
,
Kofoed
K
, et al.
Correlation Between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis Treated with Ustekinumab Acta DermVenereol
.
2018
Mar
;
98
(
3
):
335
9
.
15.
Silva
MF
,
Fortes
MR
,
Miot
LD
,
Marques
SA
.
Psoriasis: correlation between severity index (PASI) and quality of life index (DLQI) in patients assessed before and after systemic treatment
.
An Bras Dermatol
.
2013
Sep-Oct
;
88
(
5
):
760
3
.
[PubMed]
0365-0596
16.
Rigopoulos
D
,
Gregoriou
S
,
Stratigos
A
,
Larios
G
,
Korfitis
C
,
Papaioannou
D
, et al.
Evaluation of the efficacy and safety of infliximab on psoriatic nails: an unblinded, nonrandomized, open-label study
.
Br J Dermatol
.
2008
Aug
;
159
(
2
):
453
6
.
[PubMed]
0007-0963
17.
Rigopoulos
D
,
Gregoriou
S
,
Lazaridou
E
,
Belyayeva
E
,
Apalla
Z
,
Makris
M
, et al.
Treatment of nail psoriasis with adalimumab: an open label unblinded study
.
J Eur Acad Dermatol Venereol
.
2010
May
;
24
(
5
):
530
4
.
[PubMed]
0926-9959
18.
Reich
K
,
Gooderham
M
,
Bewley
A
,
Green
L
,
Soung
J
,
Petric
R
, et al.
Safety and efficacy of apremilast through 104 weeks in patients with moderate to severe psoriasis who continued on apremilast or switched from etanercept treatment: findings from the LIBERATE study
.
J Eur Acad Dermatol Venereol
.
2018
Mar
;
32
(
3
):
397
402
.
[PubMed]
0926-9959
19.
Augustin
M
,
Reich
K
,
Blome
C
,
Schäfer
I
,
Laass
A
,
Radtke
MA
.
Nail psoriasis in Germany: epidemiology and burden of disease
.
Br J Dermatol
.
2010
Sep
;
163
(
3
):
580
5
.
[PubMed]
0007-0963
20.
Langenbruch
A
,
Radtke
MA
,
Gutknecht
M
,
Augustin
M
.
Does the Dermatology Life Quality Index (DLQI) underestimate the disease- specific burden of psoriasis patients?
J Eur Acad Dermatol Venereol
.
2018
Aug
;
•••
: ; [
Epub ahead of print
].
[PubMed]
0926-9959
21.
Kim
HJ
,
Lebwohl
MG
.
Biologics and Psoriasis: The Beat Goes On
.
[Epub 2018 Nov1]
.
Dermatol Clin
.
2019
Jan
;
37
(
1
):
29
36
.
[PubMed]
0733-8635
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