Sandre MK, Rohekar S, Guenther L. Psoriatic Nail Changes Are Associated With Clinical Outcomes in Psoriatic Arthritis.
J Cutan Med Surg 2015;
19:367-76. [PMID:
25775610 DOI:
10.1177/1203475415573663]
[Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND
Nail changes are common in psoriatic arthritis (PsA), with varying relationships existing between skin, nail, and joint disease.
OBJECTIVE
To further characterize relationships between nail changes, psoriasis, and joint involvement in PsA patients.
METHODS
One hundred eighty-eight PsA patients had skin, fingernail, and rheumatological assessments completed. Hand and fingernail photographs were taken and reviewed by a dermatologist.
RESULTS
Higher swollen joint counts were associated with distal interphalangeal (DIP)/periungual psoriasis (P=.001), more splinter hemorrhages (P=.006), and any nail bed change (P=.03). Higher tender joint counts were associated with rough onychorrhexis (P<.001), DIP/periungual psoriasis (P=.03), red lunula (P=.001), nail crumbling (P=.046), any nail matrix (P=.03), and nail bed change (P=.03). Joint involvement was associated with same-digit nail changes; strongest association was swollen or tender DIP with subungual hyperkeratosis, odds ratio=26.6 (95% CI, 5.1-139.1).
CONCLUSION
The DIP/periungual psoriasis and specific nail changes were associated with higher joint counts and certain nail changes with same-digit joint involvement.
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