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Dermoscopy of nail fold and elbow in the differential diagnosis of early psoriatic arthritis sine psoriasis and early rheumatoid arthritis.
J Dermatol. 2016 Oct; 43(10):1217-1220.JD

Abstract

Differentiation between psoriatic arthritis (PsA) sine psoriasis and rheumatoid arthritis (RA) may be a challenge, especially in the early stages, hence the need for new instrumental markers to assist their diagnosis. In this study, we investigated possible dermoscopic differences in vascular appearance of nail fold and elbow (a classic site of repeated trauma) in these two conditions. Fifteen patients with PsA sine psoriasis, 12 patients with RA and 12 controls were included in the study. Regarding the nail fold vascular appearance in PsA sine psoriasis and RA cohorts, the presence of diffuse reddish background with or without sparse dotted vessels was significant in the former, whereas the evidence of parallel dotted/short linear vessels ("fish school-like" pattern) or irregular/ramified, blurry, purple vessels were significant in the latter; none of these patterns were detected in the control group. Regarding the elbow, the pattern significantly associated with PsA sine psoriasis consisted of diffusely distributed, red, dotted vessels. On the other hand, RA patients and controls displayed similar dermoscopic findings, with three possible vascular patterns being observed: (i) irregular, blurry, purple vessels; (ii) avascular appearance; and (iii) sparse, dotted, purple vessels. In conclusion, dermoscopy may be a useful supportive tool for differentiating early PsA sine psoriasis from RA.

Authors+Show Affiliations

Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy.Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy.Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy.Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy.Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy.Department of Dermatology, San Carlo Hospital, Potenza, Italy.Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy. devita.salvatore@aoud.sanita.fvg.it.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27237922

Citation

Errichetti, Enzo, et al. "Dermoscopy of Nail Fold and Elbow in the Differential Diagnosis of Early Psoriatic Arthritis Sine Psoriasis and Early Rheumatoid Arthritis." The Journal of Dermatology, vol. 43, no. 10, 2016, pp. 1217-1220.
Errichetti E, Zabotti A, Stinco G, et al. Dermoscopy of nail fold and elbow in the differential diagnosis of early psoriatic arthritis sine psoriasis and early rheumatoid arthritis. J Dermatol. 2016;43(10):1217-1220.
Errichetti, E., Zabotti, A., Stinco, G., Quartuccio, L., Sacco, S., De Marchi, G., Piccirillo, A., & De Vita, S. (2016). Dermoscopy of nail fold and elbow in the differential diagnosis of early psoriatic arthritis sine psoriasis and early rheumatoid arthritis. The Journal of Dermatology, 43(10), 1217-1220. https://doi.org/10.1111/1346-8138.13438
Errichetti E, et al. Dermoscopy of Nail Fold and Elbow in the Differential Diagnosis of Early Psoriatic Arthritis Sine Psoriasis and Early Rheumatoid Arthritis. J Dermatol. 2016;43(10):1217-1220. PubMed PMID: 27237922.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dermoscopy of nail fold and elbow in the differential diagnosis of early psoriatic arthritis sine psoriasis and early rheumatoid arthritis. AU - Errichetti,Enzo, AU - Zabotti,Alen, AU - Stinco,Giuseppe, AU - Quartuccio,Luca, AU - Sacco,Stefania, AU - De Marchi,Ginevra, AU - Piccirillo,Angelo, AU - De Vita,Salvatore, PY - 2016/02/20/received PY - 2016/03/28/accepted PY - 2016/5/31/pubmed PY - 2017/5/16/medline PY - 2016/5/31/entrez KW - dermoscopy KW - onychoscopy KW - psoriatic arthritis KW - psoriatic arthritis sine psoriasis KW - rheumatoid arthritis SP - 1217 EP - 1220 JF - The Journal of dermatology JO - J. Dermatol. VL - 43 IS - 10 N2 - Differentiation between psoriatic arthritis (PsA) sine psoriasis and rheumatoid arthritis (RA) may be a challenge, especially in the early stages, hence the need for new instrumental markers to assist their diagnosis. In this study, we investigated possible dermoscopic differences in vascular appearance of nail fold and elbow (a classic site of repeated trauma) in these two conditions. Fifteen patients with PsA sine psoriasis, 12 patients with RA and 12 controls were included in the study. Regarding the nail fold vascular appearance in PsA sine psoriasis and RA cohorts, the presence of diffuse reddish background with or without sparse dotted vessels was significant in the former, whereas the evidence of parallel dotted/short linear vessels ("fish school-like" pattern) or irregular/ramified, blurry, purple vessels were significant in the latter; none of these patterns were detected in the control group. Regarding the elbow, the pattern significantly associated with PsA sine psoriasis consisted of diffusely distributed, red, dotted vessels. On the other hand, RA patients and controls displayed similar dermoscopic findings, with three possible vascular patterns being observed: (i) irregular, blurry, purple vessels; (ii) avascular appearance; and (iii) sparse, dotted, purple vessels. In conclusion, dermoscopy may be a useful supportive tool for differentiating early PsA sine psoriasis from RA. SN - 1346-8138 UR - https://www.unboundmedicine.com/medline/citation/27237922/Dermoscopy_of_nail_fold_and_elbow_in_the_differential_diagnosis_of_early_psoriatic_arthritis_sine_psoriasis_and_early_rheumatoid_arthritis_ L2 - https://doi.org/10.1111/1346-8138.13438 DB - PRIME DP - Unbound Medicine ER -