Predicting the Risk of Nail Involvement in Psoriasis Patients: Development and Assessment of a Predictive Nomogram

Area of Science:

• Dermatology
• Clinical Prediction Modeling

Background:

• Nail involvement significantly impacts psoriasis patients' quality of life.
• Early detection and intervention are crucial for managing psoriatic nail damage.

Purpose of the Study:

• To develop and validate a predictive nomogram for assessing nail involvement in psoriasis patients.
• To identify key predictors of nail involvement for clinical risk stratification.

Main Methods:

• A cohort of 3920 psoriasis patients was analyzed.
• Univariable and multivariable logistic regression identified predictors.
• Nomogram performance was evaluated using calibration plots, ROC curves, and DCA.

Main Results:

• Key predictors included sex, age at onset, duration, smoking, allergies, comorbidities, psoriasis subtype, and specific site involvement (scalp, palmoplantar, genital), along with PASI score.
• The nomogram demonstrated satisfactory discriminative ability (AUROC = 0.745) and good clinical utility.
• Calibration analysis confirmed favorable consistency between predicted and observed risks.

Conclusions:

• A validated predictive nomogram aids clinicians in evaluating nail involvement risk in psoriasis.
• The tool supports timely intervention for psoriatic nail disease.
• This model enhances clinical decision-making for psoriasis management.