What is the eNAPPA

eNAPPA is a valid, reliable and feasible instrument for the assessment of patient-related outcomes and severity of nail psoriasis to be used in clinical studies and daily practice.

eNAPPA is comprised of three components:

 1) NAPPA-QOL measuring nail-specific quality of life. It consists of 20 items that assess specific quality of life conditions in the past week. Answers are given in scales from 0 to 4.

2) NAPPA-PBI reflecting patient-relevant needs and treatment benefits. It consists of 24 items which assess patient-defined needs before and patient-rated benefits after treatment. Answers are given in scales from 0 to 4, and a global score is calculated based on the importance-weighted benefit items.

3) NAPPA-CLIN recording objective nail status. It assesses the least and the worst involved nail of both hands, or both feet, respectively. The scores range from 0 to 16 empirically.

How to use the eNAPPA

The NAPPA-QOL and NAPPA-PBI questionnaires are filled in by the patient himself. The questionnaire is self-explanatory; yet, patients can be supported if they are not able to fill it in by themselves.The NAPPA-CLIN is filled by the dermatologist or assisting persons. This part needs a basic understanding of clinical signs at the nails.

The three components (modules) have been developed and validated on an international basis. Thus, several language versions are available. The modules can be used independently from each other.

Following you can find the versions of the eNAPPA

The impact of nail psoriasis

More than 50% of moderate to severe psoriasis patients have nail involvement which in many cases causes functional and emotional impairment and can be painful. Measurement of patient-related outcomes is essential for research and clinical care.



eNAPPA is straight-forward to use allowing it to be used by clinicians from a range of different disciplines.

Quick and Accurate Diagnosis

eNAPPA helps clinicians quickly and accurately assess nail psoriasis outcomes.

Environmentally Friendly

Put an end to wasted paper and store all your patient data in one online platform. Results can be shared via email.


eNAPPA is available in various languages for more comfortable and precise diagnostic process.

Responsive and multi-device

Your eNAPPA is always a couple of touches or clicks away, available on desktop, tablet, phone and other devices.

Multidimensional scales

The NAPPA-PBI, NAPPA-QOL and NAPPA-CLIN are part of the eNAPPA assessment.

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