Abstract
Background Psoriatic arthritis (PsA) results in an increased burden of psoriasis and impairs both quality of life and an individual's functional capacity. The relationship between nail involvement and PsA in psoriasis is not fully characterized. Aim To evaluate the frequency and characteristics of nail involvement in psoriatic patients and to assess the relationship with joint involvement. Methods A total of 197 patients with moderate-to-severe psoriasis were consecutively invited to participate in this cross-sectional study. The patients are divided into two groups: those with and those without psoriatic arthritis. Results 69.5% of psoriatic (137 out of 197) patients had nail involvement. The most common nail abnormality was onycholysis, followed by pitting and oil droplet changes. Nail involvement was more common in patients with psoriatic arthritis (82.1% versus 57.8%, p=0.001). Conclusion Nail involvement is commonly associated with PsA. Onycholysis, splinter hemorrhage, and oil drop were significantly more common in the PsA group as opposed to patients with just skin findings. In general, psoriatic patients with arthritis had more severe disease.
Highlights
Psoriasis is a chronic inflammatory disease affecting up to 3% of the general population
Moderate-to-severe psoriasis was defined as body surface area (BSA) >10% or psoriasis area and severity index (PASI) >10 [10]
Nail involvement in psoriasis usually is divided into two major groups: (a) signs of involvement of nail matrix including pitting, leukonychia, red spots of the lunula, transverse grooves (Beau’s lines), and crumbling of the nail plate and (b) signs of involvement of the nail bed which present as oil-drop discoloration, splinter hemorrhages, subungual hyperkeratosis, and onycholysis [5]
Summary
Psoriasis is a chronic inflammatory disease affecting up to 3% of the general population. It has a substantial negative impact on health-related quality of life (HRQOL), especially when it involves visible areas of the body such as the face, hands, and nails [1]. The exact prevalence of PsA is unknown but up to 30% of patients with psoriasis develop psoriatic arthritis [2, 3]. The aim of this study was to assess the overall prevalence of nail involvement in patients with moderate-to-severe psoriasis and to achieve more details on the possible relationship between nail psoriasis and PsA. Onycholysis, splinter hemorrhage, and oil drop were significantly more common in the PsA group as opposed to patients with just skin findings. Psoriatic patients with arthritis had more severe disease
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