Nail involvement can predict enthesopathy in patients with psoriasis

Castellanos-González, María; Joven, Beatriz; Sánchez, Julio; Andrés-Esteban, Eva María; Vanaclocha-Sebastián, F.; Romero, Pablo Ortiz; Díaz, Raquel Rivera

doi:10.1111/ddg.12989

Cited by 33 publications

(32 citation statements)

References 13 publications

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“…In another study, Castellanos-González et al conducted US examinations in patients with Ps and found the presence of enthesopathy in 31% of patients with onycholysis. The frequency of changes in the digital extensor tendon or its attachment in the DIP joint of digits with nail involvement was nearly 83% [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Assessment of Changes in Nails in Psoriasis and Psoriatic Arthritis

Krajewska–Włodarczyk

Owczarczyk‐Saczonek

Placek

et al. 2018

BioMed Research International

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Aim of the Study The aim of the study was to conduct an ultrasound (US) assessment of changes in fingernails in psoriatic patients with nail involvement. Material A total of 69 patients with psoriatic changes in nails participated in the study, including 38 patients with psoriasis (Ps) and 31 with psoriatic arthritis (PsA) and 30 people in the control group. A total of 988 nails were examined. Results The thickness of the nail plate, nail bed, and matrix as shown in an ultrasound examination increased with the mNAPSI index (r=0.328, p=0.021; r=0.219, p=0.036; and r=0.422, p=0.011, respectively). The thickness of nail plate, bed, and matrix in patients with onycholysis and hyperkeratosis-type changes (concomitant or present separately) was significantly greater than when only pitting-type changes occurred (p=0.007, p=0.035, and p=0.023, respectively). An examination of nails with only pitting-type changes showed an increase in the matrix thickness compared to the control group (p=0.018). The focal hyperechoic involvement of the dorsal plate (80%) was the change most often observed in an US examination in Ps patients, whereas loosening of the borders of the ventral plate was most often observed in PsA patients. The thickness of nail bed in PsA patients increased with the duration of arthritis (r=0.399, p=0.022) and was correlated with the number of swollen digits (r=0.278, p=0.041). Conclusions The findings of this study may indicate an association of an inflammation in the nail bed with PsA development. Apart from a direct assessment of the described morphological changes of nails, a US examination could prove useful in an assessment of intensity of a local inflammation as a prognostic factor for PsA development.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Assessment of Changes in Nails in Psoriasis and Psoriatic Arthritis

Krajewska–Włodarczyk

Owczarczyk‐Saczonek

Placek

et al. 2018

BioMed Research International

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“…The nail bed is also graded 0–4 for onycholysis, splinter hemorrhages, subungual hyperkeratosis and oil drops. There is a significant correlation between target NAPSI score and evidence of enthesopathy in the course of PsA [14]. …”

Section: Resultsmentioning

confidence: 99%

Nail psoriasis – what a rheumatologist should know about

Nieradko-Iwanicka

2017

Reumatologia

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Psoriasis is a chronic recurrent inflammatory skin disease with prevalence of 1–3%. Nail psoriasis affects 10–90% of patients with plaque psoriasis.The aim of the article is to review the literature for the correlation between nail psoriasis and psoriatic arthritis (PsA) to provide rheumatologists a short review on features of nail psoriasis, methods of their assessment and possible clinical repercussions.The PubMed database was searched using the key words ‘nail psoriasis’ and ‘psoriatic arthritis’. Psoriasis involving the nail matrix shows up as changes such as pitting, Beau lines, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis manifests as onycholysis, oil drops (or salmon patches), dyschromia, splinter hemorrhages, or subungual hyperkeratosis. Nail psoriasis and psoriatic lesions in the gluteal cleft and on the scalp usually accompany PsA, especially in adult men.

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“…Moreover, Castellanos-Gonzalez et al [ 15 ] showed that the clinical presence of onychopathy is a predictor of US enthesitis at DIP level in patients with psoriasis.…”

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confidence: 99%

“…On the other hand, data related to the utility of US to predict the progress of the disease are emerging [ 5 , 10 , 15 ]. US has shown that the central inflammatory change in PsA takes place in the entheseal compartment.…”

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confidence: 99%

Ultrasound as a useful tool to integrate the clinical assessment of nail involvement in psoriatic arthritis

et al. 2018

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Developing the skills to adequately assess nail lesions in psoriasis is mandatory for correct interpretation of the pathological features and to provide correct management of psoriatic patients. Although clinical assessment is part of an accurate diagnosis of nail psoriasis, recent advances in the field of imaging are generating growing interest among clinicians exploring its potential role for the assessment of nail psoriasis. We would like to address the attention to ultrasound (US), which is having an impact in different clinical scenarios such as diagnosis, prognosis, and treatment monitoring of nail involvement in psoriatic disease

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Nail involvement can predict enthesopathy in patients with psoriasis

Abstract: Clinical evidence of onychopathy may be the clue to an early diagnosis of enthesopathy in psoriasis patients.

Cited by 33 publications

References 13 publications

Ultrasound Assessment of Changes in Nails in Psoriasis and Psoriatic Arthritis

Ultrasound Assessment of Changes in Nails in Psoriasis and Psoriatic Arthritis

Nail psoriasis – what a rheumatologist should know about

Ultrasound as a useful tool to integrate the clinical assessment of nail involvement in psoriatic arthritis

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