Fingernail Involvement is a Bigger Burden Than Face and Scalp Involvement in Patients With Psoriasis

Background: Psoriasis can cause considerable emotional distress. There are a small amount of data regarding this subject. Objective: To evaluate distress in patients with psoriasis. Methods: We studied the impact of scalp, face, and fingernail involvement in 118 patients with psoriasis between October 2017 and March 2018 in Kurume University Hospital using Dermatology Life Quality Index (DLQI). Results: Dermatology Life Quality Index was significantly higher in patients with scalp, face, and fingernail involvement. Psoriasis area and severity index (PASI) was significantly higher in those with scalp and face involvement; however, no significant difference was found in the PASI of the patients with and without fingernail involvement. In the subcohorts with low PASI, there was no significant difference of DLQI between patients with and without scalp and face involvement; however, DLQI in patients with fingernail involvement was significantly higher than that in those without nail involvement. Conclusion: Fingernail involvement is a big burden even in patients with mild psoriasis.