Nail psoriasis as a severity indicator: results from the PsoReal study

Abstract

Background:Although nail psoriasis affects a substantial proportion of psoriasis patients and causes significant psychologic distress, few epidemiologic data characterizing patients with nail involvement are available. The aim of this research was to elucidate differences between patients with nail psoriasis and those without any nail involvement, taking quality indicators of health care from the patient’s perspective into account.Methods:In total, 2449 patient members of the Deutscher Psoriasis Bund, the largest patient organization for psoriasis in Germany, were interviewed in this nationwide, noninterventional, cross-sectional study. Patients with nail psoriasis were compared with patients without any nail involvement with regard to gender, age, disease duration, affected body surface area, health-related quality of life (Dermatology Life Quality Index [DLQI] ED-5D), patient-defined treatment benefit, amount of inpatient treatments, disease duration, and numbers of work days lost.Results:Data from 2449 patients with psoriasis were analyzed. Overall, 44.8% (1078) of patients were female, mean age was 57.0 ± 11.7 years, and 72.8% had nail involvement and showed higher values for affected body surface area than those without nail involvement (8.3% versus 5.6%, respectively; P < 0.004). Health-related quality of life was significantly lower in patients with nail psoriasis (DLQI 7.2 versus 5.3; ED-5D 60.1 versus 67.3), who had more days off work (9.8 versus 3.3).Conclusion:Nail involvement is an important symptom of psoriasis and is associated with greater disease severity and quality of life impairment. Accordingly, management of psoriasis should include a special focus on nail involvement.

Health-Related Quality of Life in Patients with Nail Disorders

“…[2,6,7] Nail psoriasis occurs more often in patients with more severe psoriasis and there is a positive correlation between the severity of nail lesions and the severity of joint and skin symptoms. [2,8,9] However, nail abnormalities may be the only manifestation of psoriasis and are also frequently seen in patients with mild disease. [2] Nail involvement may manifest as nail pitting (small depressions in the nail plate), nail bed discoloration ('salmon spots' or 'oil drops'), subungual hyperkeratosis, nail plate thickening and crumbling, onycholysis, splinter hemorrhages, leukonychia, and red spots in the lunula.…”

Determining the Prevalence and Types of Nail Involvement in Patients with Severe Acne Vulgaris Who Referred to Clinic of Dermatology of Rasoul-e-akram Hospital During 2010-2011

“…However, it is reported that in patients with psoriasis nail involvement in addition to patient age was significantly related to disease severity (16). Given that all of the patients in this study were in severe stages of acne vulgaris and patients with moderate and mild acne vulgaris were not included in present study, no judgment is possible based on the severity and extent of acne lesions in these people and its relationship with nail lesions.…”

Osteoarticular Injury in Psoriatic Patients According to the Data of Pest (Psoriasis Epidemiology Screening Tool) Questionnaire and Rheumatological Clinicoinstrumental Examination

“…M. Radtke и соавт. [15] показали, что псориаз ногтей является предикто-ром тяжелого течения псориаза и увеличивает вероятность ПсА до 70-80%. V. Azevedo и соавт.…”