Back to Search
Start Over
Psoriatic Nail Dystrophy Is Associated with Erosive Disease in the Distal Interphalangeal Joints in Psoriatic Arthritis: A Retrospective Cohort Study.
- Source :
-
The Journal of rheumatology [J Rheumatol] 2019 Sep; Vol. 46 (9), pp. 1097-1102. Date of Electronic Publication: 2019 Mar 01. - Publication Year :
- 2019
-
Abstract
- Objective: To assess whether the association between psoriatic nail dystrophy and radiographic damage in the hands of patients with psoriatic arthritis (PsA) is specific to the distal interphalangeal (DIP) joints.<br />Methods: A convenience sample of patients was collated from the Bath longitudinal PsA cohort. All patients had PsA according to the ClASsification for Psoriatic ARthritis criteria (CASPAR) criteria, scored radiographs of their hands, and documented nail scores as measured by the Psoriatic Nail Severity Score. Chi-square tests were performed to examine for association between features of nail dystrophy and radiographic damage in the DIP joints, and proximal interphalangeal or metacarpophalangeal (non-DIP) joints of the corresponding digits.<br />Results: There were 134 patients included, with a median age of 53 years (interquartile range; IQR 44-61) and disease duration of 7 years (IQR 3-17). The presence of any form of psoriatic nail dystrophy was associated with erosion at the DIP joints of the corresponding digit (OR 1.9, 95% CI 1.23-2.83; p < 0.004) and this association was primarily driven by the presence of nail onycholysis (OR 1.72; 95% CI 1.12-2.62; p = 0.02). Nail subungual hyperkeratosis was more strongly associated with joint space narrowing, erosions, and osteoproliferation at the corresponding DIP joint compared to non-DIP joints (p < 0.001). Nail pitting was not associated with erosions or osteoproliferation.<br />Conclusion: The presence of psoriatic nail dystrophy, particularly onycholysis, is associated with erosive disease at the DIP joints. Subungual hyperkeratosis is more strongly associated with erosive damage at the DIP than non-DIP joints. These findings support the anatomical and pathological link between nail and DIP joint disease.
- Subjects :
- Adult
Arthritis, Psoriatic diagnostic imaging
Finger Joint diagnostic imaging
Humans
Male
Middle Aged
Nail Diseases diagnostic imaging
Nails diagnostic imaging
Radiography
Retrospective Studies
Severity of Illness Index
Toe Joint diagnostic imaging
Arthritis, Psoriatic pathology
Finger Joint pathology
Nail Diseases pathology
Nails pathology
Toe Joint pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0315-162X
- Volume :
- 46
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The Journal of rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 30824637
- Full Text :
- https://doi.org/10.3899/jrheum.180796