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Psoriatic nail involvement and its relationship with distal interphalangeal joint disease.
Clin Rheumatol. 2016 Aug; 35(8):2031-2037.CR

Abstract

Psoriatic nail disease and distal interphalangeal (DIP) arthritis both are common manifestations of psoriatic arthritis (PsA). Several clinical characteristics are allegedly associated with DIP joint damage, particularly nail psoriasis. However, there is little evidence to substantiate this phenomenon. The purpose of this study is to investigate the relationship between DIP involvement, nail psoriasis and other parameters. A cross-sectional study involved 45 patients from local rheumatology clinic. Four hundred fifty psoriatic fingernails scored, and the radiographs of all these fingers were reviewed to define PsA DIP arthritic changes. 64.4 % patients had nail psoriasis and 35.6 % had DIP arthritis. Univariate analysis identified that swollen joint-count, digits with chronic dactylitis, HLA-B27 status and nail psoriasis were associated with DIP arthritis. Regression model supported that nail disease was the most significant associated factor of DIP arthritis (OR 9.7, p = 0.05). Nail psoriasis was identified in 40.2 % of digits. Pitting (29.6 %), onycholysis (15.1 %), crumbling (8.2 %), nail bed hyperkeratosis (2.0 %) were noted with the mean modified Nail Psoriasis Severity Index of 0.95 +/-1.68. Among all digits, 57 had DIP arthritis while 393 did not. Within DIP joints with PsA radiological change, 59.6 % had nail disease. Chi-square test with the Bonferroni correction further supported an association between nail psoriasis and DIP involvement with p value of 0.001. Two specific nail subtypes-crumbling and onycholysis-were found to be significantly associated with DIP disease. A significant proportion of PsA patients had nail involvement and DIP arthritis. PsA patients with nail changes may be more susceptible to DIP disease.

Authors+Show Affiliations

Rheumatology Unit, Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong. laitl@ha.org.hk.Rheumatology Unit, Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong.Department of Radiology, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong.Rheumatology Unit, Department of Medicine and Geriatrics, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27251673

Citation

Lai, T L., et al. "Psoriatic Nail Involvement and Its Relationship With Distal Interphalangeal Joint Disease." Clinical Rheumatology, vol. 35, no. 8, 2016, pp. 2031-2037.
Lai TL, Pang HT, Cheuk YY, et al. Psoriatic nail involvement and its relationship with distal interphalangeal joint disease. Clin Rheumatol. 2016;35(8):2031-2037.
Lai, T. L., Pang, H. T., Cheuk, Y. Y., & Yip, M. L. (2016). Psoriatic nail involvement and its relationship with distal interphalangeal joint disease. Clinical Rheumatology, 35(8), 2031-2037. https://doi.org/10.1007/s10067-016-3319-5
Lai TL, et al. Psoriatic Nail Involvement and Its Relationship With Distal Interphalangeal Joint Disease. Clin Rheumatol. 2016;35(8):2031-2037. PubMed PMID: 27251673.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psoriatic nail involvement and its relationship with distal interphalangeal joint disease. AU - Lai,T L, AU - Pang,H T, AU - Cheuk,Y Y, AU - Yip,M L, Y1 - 2016/06/01/ PY - 2015/11/01/received PY - 2016/05/22/accepted PY - 2016/05/16/revised PY - 2016/6/3/entrez PY - 2016/6/3/pubmed PY - 2017/2/14/medline KW - Distal interphalangeal joint arthritis KW - Nail psoriasis KW - Psoriatic nail disease SP - 2031 EP - 2037 JF - Clinical rheumatology JO - Clin. Rheumatol. VL - 35 IS - 8 N2 - Psoriatic nail disease and distal interphalangeal (DIP) arthritis both are common manifestations of psoriatic arthritis (PsA). Several clinical characteristics are allegedly associated with DIP joint damage, particularly nail psoriasis. However, there is little evidence to substantiate this phenomenon. The purpose of this study is to investigate the relationship between DIP involvement, nail psoriasis and other parameters. A cross-sectional study involved 45 patients from local rheumatology clinic. Four hundred fifty psoriatic fingernails scored, and the radiographs of all these fingers were reviewed to define PsA DIP arthritic changes. 64.4 % patients had nail psoriasis and 35.6 % had DIP arthritis. Univariate analysis identified that swollen joint-count, digits with chronic dactylitis, HLA-B27 status and nail psoriasis were associated with DIP arthritis. Regression model supported that nail disease was the most significant associated factor of DIP arthritis (OR 9.7, p = 0.05). Nail psoriasis was identified in 40.2 % of digits. Pitting (29.6 %), onycholysis (15.1 %), crumbling (8.2 %), nail bed hyperkeratosis (2.0 %) were noted with the mean modified Nail Psoriasis Severity Index of 0.95 +/-1.68. Among all digits, 57 had DIP arthritis while 393 did not. Within DIP joints with PsA radiological change, 59.6 % had nail disease. Chi-square test with the Bonferroni correction further supported an association between nail psoriasis and DIP involvement with p value of 0.001. Two specific nail subtypes-crumbling and onycholysis-were found to be significantly associated with DIP disease. A significant proportion of PsA patients had nail involvement and DIP arthritis. PsA patients with nail changes may be more susceptible to DIP disease. SN - 1434-9949 UR - https://www.unboundmedicine.com/medline/citation/27251673/Psoriatic_nail_involvement_and_its_relationship_with_distal_interphalangeal_joint_disease_ L2 - https://dx.doi.org/10.1007/s10067-016-3319-5 DB - PRIME DP - Unbound Medicine ER -