{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:10:53Z","timestamp":1780733453816,"version":"3.54.1"},"reference-count":36,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Psoriatic onychopathy is one of the clinical presentations of psoriasis and a well-known risk factor for the development of psoriatic arthritis. High-frequency ultrasounds (HFUS &gt; 20 MHz) have recently been used to evaluate the nail apparatus of healthy and psoriatic subjects. The aim of our study was to detect by means of ultra-high-frequency ultrasound (UHFUS 70\u2013100 MHz) alterations of the nail bed and matrix in patients with psoriatic onychopathy and to monitor these parameters during the treatment with monoclonal antibody (mAb). We enrolled 10 patients with psoriatic onychopathy and naive to previous biologic therapies. Patients were evaluated at baseline, after 1 month and after 3 months from the beginning of mAb therapy by a complete clinical assessment and US evaluation. A UHFUS examination with a 70 MHz probe was performed on the thumbnail (I), the index fingernail (II) and the nail with greater clinical impairment (W). The following measurements were analyzed: nail plate thickness (A), nail bed thickness (B), nail insertion length (C), nail matrix length (D) and nail matrix thickness (E). Among the various parameters analyzed, some measures showed a statistically significant decrease with p-value &lt; 0.05 (t0 WA = 0.52 mm vs. t2 WA = 0.42 mm; t0 WB = 2.8 mm vs. t2 WB = 2.4 mm; t0 WE = 0.76 mm vs. t2 WE = 0.64 mm; t0 IIA = 0.49 mm vs. t2 IIA = 0.39 mm). In conclusion, UHFUS could represent a viable imaging technique for the real-time evaluation and monitoring of psoriatic onychopathy, thus supporting the clinical parameters and revealing any subclinical signs of early drug response.<\/jats:p>","DOI":"10.3390\/diagnostics13162716","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T08:53:31Z","timestamp":1692608011000},"page":"2716","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Assessment and Monitoring of Nail Psoriasis with Ultra-High Frequency Ultrasound: Preliminary Results"],"prefix":"10.3390","volume":"13","author":[{"given":"Alessandra","family":"Michelucci","sequence":"first","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Dini","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Salvia","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6788-3253","authenticated-orcid":false,"given":"Giammarco","family":"Granieri","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Manzo Margiotta","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Panduri","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-0262","authenticated-orcid":false,"given":"Riccardo","family":"Morganti","sequence":"additional","affiliation":[{"name":"Statistical Support to Clinical Trials Department, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-0141","authenticated-orcid":false,"given":"Marco","family":"Romanelli","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/S0140-6736(20)32549-6","article-title":"Psoriasis","volume":"397","author":"Griffiths","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.ad.2022.01.032","article-title":"Nail Psoriasis","volume":"113","author":"Puig","year":"2022","journal-title":"Actas Dermosifiliogr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1038\/s41584-019-0175-0","article-title":"Preventing psoriatic arthritis: Focusing on patients with psoriasis at increased risk of transition","volume":"15","author":"Scher","year":"2019","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_4","first-page":"231","article-title":"Early predictors of psoriatic arthritis: A Delphi-based consensus from Italian dermatology centers","volume":"157","author":"Messina","year":"2022","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.2147\/CCID.S417679","article-title":"Nail Psoriasis: An Updated Review of Currently Available Systemic Treatments","volume":"16","author":"Battista","year":"2023","journal-title":"Clin Cosmet Investig Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1067\/S0190-9622(03)00910-1","article-title":"Nail Psoriasis Severity Index: A useful tool for evaluation of nail psoriasis","volume":"49","author":"Rich","year":"2003","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s10067-009-1292-y","article-title":"A sonographic spectrum of psoriatic arthritis: \u201cThe five targets\u201d","volume":"29","author":"Gutierrez","year":"2010","journal-title":"Clin. Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1016\/j.berh.2008.09.006","article-title":"Imaging of seronegative spondyloarthritis","volume":"22","author":"Tan","year":"2008","journal-title":"Best. Pract. Res. Clin. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s40265-014-0191-y","article-title":"Managing patients with psoriatic disease: The diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis","volume":"74","author":"Mease","year":"2014","journal-title":"Drugs"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s40477-017-0253-6","article-title":"Nail unit ultrasound: A complete guide of the nail diseases","volume":"20","year":"2017","journal-title":"J. Ultrasound."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s10067-019-04437-0","article-title":"The ultrasonographic study of the nail reveals differences in patients affected by inflammatory and degenerative conditions","volume":"38","author":"Idolazzi","year":"2019","journal-title":"Clin. Rheumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"164","DOI":"10.2340\/00015555-3060","article-title":"Ultrasound Assessment of Psoriatic Onychopathy: A Cross-sectional Study Comparing Psoriatic Onychopathy with Onychomycosis","volume":"99","author":"Moreno","year":"2019","journal-title":"Acta Derm. Venereol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Krajewska-W\u0142odarczyk, M., and Owczarczyk-Saczonek, A. (2022). Usefulness of Ultrasound Examination in the Assessment of the Nail Apparatus in Psoriasis. Int. J. Env. Res. Public. Health, 19.","DOI":"10.3390\/ijerph19095611"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"688","DOI":"10.3899\/jrheum.170146","article-title":"Nail Enthesis Ultrasound in Psoriasis and Psoriatic Arthritis: A Report from the 2016 GRAPPA Annual Meeting","volume":"44","author":"Cunha","year":"2017","journal-title":"J. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/1346-8138.13495","article-title":"Ultra high-frequency ultrasound: New capabilities for nail anatomy exploration","volume":"44","author":"Berritto","year":"2017","journal-title":"J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/srt.12942","article-title":"Ultra-high-frequency ultrasound monitoring of plaque psoriasis during Ixekizumab treatment","volume":"27","author":"Dini","year":"2021","journal-title":"Ski. Res. Technol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1177\/0846537120940684","article-title":"Ultra-High Frequency Ultrasound, A Promising Diagnostic Technique: Review of the Literature and Single-Center Experience","volume":"72","author":"Izzetti","year":"2021","journal-title":"Can. Assoc. Radiol. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/exd.14330","article-title":"Ultra-high-frequency ultrasound and machine learning approaches for the differential diagnosis of melanocytic lesions","volume":"31","author":"Faita","year":"2022","journal-title":"Exp. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4103\/ijd.IJD_539_16","article-title":"Evidence and Suggested Therapeutic Approach in Psoriasis of Difficult-to-treat Areas: Palmoplantar Psoriasis, Nail Psoriasis, Scalp Psoriasis, and Intertriginous Psoriasis","volume":"62","author":"Sarma","year":"2017","journal-title":"Indian. J. Dermatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"620562","DOI":"10.3389\/fmed.2021.620562","article-title":"Efficacy of Systemic Treatments of Nail Psoriasis: A Systemic Literature Review and Meta-Analysis","volume":"8","author":"Zhang","year":"2021","journal-title":"Front. Med."},{"key":"ref_21","first-page":"123","article-title":"The modified Nail Psoriasis Severity Index: Validation of an instrument to assess psoriatic nail involvement in patients with psoriatic arthritis","volume":"34","author":"Cassell","year":"2007","journal-title":"J. Rheumatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1365-2230.1994.tb01167.x","article-title":"Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use","volume":"19","author":"Finlay","year":"1994","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1111\/exd.14664","article-title":"Ultra-high frequency ultrasound detection of the dermo-epidermal junction: Its potential role in dermatology","volume":"31","author":"Granieri","year":"2022","journal-title":"Exp. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"686470","DOI":"10.3389\/fmed.2021.686470","article-title":"High-Frequency Ultrasonography and Evaporimetry in Non-invasive Evaluation of the Nail Unit","volume":"8","author":"Jenerowicz","year":"2021","journal-title":"Front. Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Agache, M., Popescu, C.C., Enache, L., Dumitrescu, B.M., and Codreanu, C. (2023). Nail Ultrasound in Psoriasis and Psoriatic Arthritis-A Narrative Review. Diagnostics, 13.","DOI":"10.3390\/diagnostics13132236"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s10067-010-1623-z","article-title":"The role of ultrasound in rheumatic skin and nail lesions: A multispecialist approach","volume":"30","author":"Wortsman","year":"2011","journal-title":"Clin. Rheumatol."},{"key":"ref_27","first-page":"137","article-title":"Ultrasound anatomy of normal nails unit with 18 mHz linear transducer","volume":"114","author":"Cecchini","year":"2009","journal-title":"Ital. J. Anat. Embryol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s00403-012-1274-9","article-title":"Ultrasonography reveals nail thickening in patients with chronic plaque psoriasis","volume":"304","author":"Gisondi","year":"2012","journal-title":"Arch. Dermatol. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.ejrnm.2015.04.009","article-title":"Ultrasonographic characterization of the nails in patients with psoriasis and onychomycosis","volume":"46","author":"Atwa","year":"2015","journal-title":"Egypt. J. Radiol. Nucl. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/RHU.0000000000000054","article-title":"Ultrasound nail imaging on patients with psoriasis and psoriatic arthritis compared with rheumatoid arthritis and control subjects","volume":"20","author":"Sandobal","year":"2014","journal-title":"J. Clin. Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"312","DOI":"10.11152\/mu.2013.2066.183.hgh","article-title":"High-frequency sonography in the evaluation of nail psoriasis","volume":"18","author":"Marina","year":"2016","journal-title":"Med. Ultrason."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"42","DOI":"10.5114\/reum.2018.74749","article-title":"Ultrasound as a useful tool to integrate the clinical assessment of nail involvement in psoriatic arthritis","volume":"56","author":"Gutierrez","year":"2018","journal-title":"Reumatologia"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Krajewska-W\u0142odarczyk, M., Owczarczyk-Saczonek, A., Placek, W., Wojtkiewicz, M., and Wojtkiewicz, J. (2018). Effect of Methotrexate in the Treatment of Distal Interphalangeal Joint Extensor Tendon Enthesopathy in Patients with Nail Psoriasis. J. Clin. Med., 7.","DOI":"10.3390\/jcm7120546"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Krajewska-W\u0142odarczyk, M., Zuber, Z., and Owczarczyk-Saczonek, A. (2021). Ultrasound Evaluation of the Effectiveness of the Use of Acitretin in the Treatment of Nail Psoriasis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10102122"},{"key":"ref_35","first-page":"8251097","article-title":"Ultrasound Assessment of Changes in Nails in Psoriasis and Psoriatic Arthritis","volume":"2018","author":"Placek","year":"2018","journal-title":"BioMed Res. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1468-3083.2009.03363.x","article-title":"Enthesitis: An autoinflammatory lesion linking nail and joint involvement in psoriatic disease","volume":"23","author":"McGonagle","year":"2009","journal-title":"J. Eur. Acad. Dermatol. Venereol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/16\/2716\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:38:34Z","timestamp":1760128714000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/16\/2716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,21]]},"references-count":36,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["diagnostics13162716"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13162716","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,21]]}}}