Psoriatic Nail Changes Are Associated With Clinical Outcomes in Psoriatic Arthritis

Journal of Cutaneous Medicine and Surgery
Matthew K SandreLyn Guenther

Abstract

Nail changes are common in psoriatic arthritis (PsA), with varying relationships existing between skin, nail, and joint disease. To further characterize relationships between nail changes, psoriasis, and joint involvement in PsA patients. One hundred eighty-eight PsA patients had skin, fingernail, and rheumatological assessments completed. Hand and fingernail photographs were taken and reviewed by a dermatologist. 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). 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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Citations

Nov 5, 2016·International Journal of Dermatology·Roger HaberRoland Tomb
Sep 8, 2016·The Journal of Dermatology·Jee Woong ChoiSang Woong Youn
Oct 20, 2015·Journal of Cutaneous Medicine and Surgery·Matthew K SandreLyn Guenther
Aug 8, 2017·British Journal of Hospital Medicine·Geraint A BrownCoziana Ciurtin
Feb 12, 2019·Journal of Cutaneous Medicine and Surgery·Charles W LyndeGordon E Searles

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