Authors : Shikha Khare, Tamal Trivedi
DOI : 10.18231/j.pjms.2020.034
Volume : 10
Issue : 2
Year : 2020
Page No : 162-166
Introduction: Psoriasis is a common chronic autoimmune inflammatory multisystem disease mainly
involving skin, nails and joints. Several studies have reported lower levels of vitamin D and calcium in
psoriasis. But there is paucity of literature regarding levels of vitamin D and calcium in nail psoriasis.
Objective: To study the level of Vitamin D and calcium in psoriasis patients with nail involvement and to
correlate their levels with nail severity using Nail Psoriasis Severity Index (NAPSI).
Materials and Methods: A total of 60 psoriasis patients with nail changes were recruited for the study. The
severity of nail changes was calculated using Nail Psoriasis Severity Index (NAPSI). All non-specific nail
changes which were present in the psoriasis patients were noted as well. Apart from routine investigations,
blood calcium level and serum vitamin D levels were also sent for investigation.
Results: Majority of the participants were male with male: female ratio of 2.75:1. The mean age at of onset
of nail involvement was 42.87 17.19 years. About three-fourth of the patients were hypocalcaemic and
vitamin D deficient or insufficient. There was a moderate negative correlation between NAPSI and blood
calcium (mg/dL), and it was statistically significant (rho = -0.33, P = 0.011). There was a weak positive
correlation between NAPSI and S. Vitamin-D (ng/mL), and this correlation was not statistically significant
(rho = 0.11, P = 0.402). However, on multivariate regression analysis of NAPSI, significant association was
found between nail psoriasis severity index (NAPSI) with blood calcium level and serum vitamin D levels
(P=0.01).
Conclusion: Blood calcium and serum vitamin D levels were found low in patients of nail psoriasis. Hence,
oral vitamin D and calcium supplementation may aid in the earlier response to standard nail psoriasis
treatment and further studies are required to prove the therapeutic effect of calcium and vitamin D in nail
psoriasis.
Keywords: Calcium, Vitamin D, Nail, Psoriasis, NAPSI.