Changes in the nails can be attributed to psoriasis. Using nail clippings to confirm a psoriasis diagnosis or to rule out a nail fungus is useful because nail clipping is painless and can be repeated as often as needed.
A recent study used two different indices that classify nail changes to evaluate clippings from children and adolescents with skin psoriasis. The study’s aim was to determine whether nail clippings can be useful for determining the diagnosis, prognosis, and progression of psoriasis.
Using clippings from 52 children from a pediatric clinic, the authors looked for visible nail changes such as pitting of the nail plate or white spots, and microscopic features such as serous lakes and presence of neutrophils. The results showed that there seems to be a correlation between microscopic nail features in children with psoriasis and higher scores on skin and nail disease severity indices.
Based on these data, the authors conclude that nail clippings can be useful in children with suspected psoriasis, they can help rule out onychomycosis, and also in confirming the psoriasis diagnosis, especially if neutrophils are present. They note that the sample is small, but the findings encourage more studies of nail clipping histopathology in children with psoriasis.