Maria Laura Acosta-Felquer1, Santiago Ruta1, Javier Rosa1, Josefina Marin1, Leandro Ferreyra-Garrot1, Maria Laura Galimberti2, Ricardo Galimberti2, Ricardo Garcia-Monaco3, Enrique R Soriano4. 1. Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, University Institute Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 2. Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 3. Radiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 4. Rheumatology Unit, Internal Medicine Department, Hospital Italiano de Buenos Aires, University Institute Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fundacion Dr. Pedro M. Catoggio para el Progreso de la Reumatología, Buenos Aires, Argentina. Electronic address: enrique.soriano@hospitalitaliano.org.ar.
Abstract
OBJECTIVE: It has been shown that nail involvement in psoriasis is associated with systemic enthesopathy. Our objective was to evaluate the association of nail involvement and enthesopathy at distal interphalangeal joint (DIP) level in psoriasis (PsO) and psoriatic arthritis (PsA) patients. METHODS: Consecutive patients (54 PsO and 56 PsA) seen at the outpatients clinic in this cross-sectional study were included. All patients underwent both clinical and ultrasound (US) assessment on the same day. RESULTS: US revealed enthesopathy in at least 1 DIP joint in 9 patients with PsO (17%, 95% CI: 8-29%) and in 18 patients with PsA (32%, 95% CI: 20-46%). US extensor tendon enthesopathy was detected in a higher proportion of fingers with clinical nail involvement compared with fingers without clinical nail involvement, both in PsO and PsA patients (61.2% vs 16.8%, p < 0.0001 and 60.1% vs 22%, p < 0.0001, respectively). Among patients with PsO, 20% (95% CI: 7-41%) and 14% (95% CI: 4-32%) of those with and without clinical nail involvement showed enthesopathy on US examination, respectively (p = 0.54). Among PsA patients, the prevalence of enthesopathy was 30% (95% CI: 15-49%) for patients with clinical nail involvement and 35% (95% CI: 17-56%) for those without nail involvement (p = 0.71). CONCLUSION: Nail disease was associated with DIP US enthesopathy. There was a significant increased prevalence of extensor tendon enthesopathy in fingers with involved nails both in PsO and PsA, although no association was found between nail involvement and extensor tendon enthesopathy at patients' level. These features might support the nail-entheseal pathogenesis theory at DIP level.
OBJECTIVE: It has been shown that nail involvement in psoriasis is associated with systemic enthesopathy. Our objective was to evaluate the association of nail involvement and enthesopathy at distal interphalangeal joint (DIP) level in psoriasis (PsO) and psoriatic arthritis (PsA) patients. METHODS: Consecutive patients (54 PsO and 56 PsA) seen at the outpatients clinic in this cross-sectional study were included. All patients underwent both clinical and ultrasound (US) assessment on the same day. RESULTS: US revealed enthesopathy in at least 1 DIP joint in 9 patients with PsO (17%, 95% CI: 8-29%) and in 18 patients with PsA (32%, 95% CI: 20-46%). US extensor tendon enthesopathy was detected in a higher proportion of fingers with clinical nail involvement compared with fingers without clinical nail involvement, both in PsO and PsA patients (61.2% vs 16.8%, p < 0.0001 and 60.1% vs 22%, p < 0.0001, respectively). Among patients with PsO, 20% (95% CI: 7-41%) and 14% (95% CI: 4-32%) of those with and without clinical nail involvement showed enthesopathy on US examination, respectively (p = 0.54). Among PsA patients, the prevalence of enthesopathy was 30% (95% CI: 15-49%) for patients with clinical nail involvement and 35% (95% CI: 17-56%) for those without nail involvement (p = 0.71). CONCLUSION: Nail disease was associated with DIP US enthesopathy. There was a significant increased prevalence of extensor tendon enthesopathy in fingers with involved nails both in PsO and PsA, although no association was found between nail involvement and extensor tendon enthesopathy at patients' level. These features might support the nail-entheseal pathogenesis theory at DIP level.
Authors: Piero Ruscitti; Maria Esposito; Camilla Gianneramo; Paola Cipriani; Antonio Barile; Maria Concetta Fargnoli; Ilenia Di Cola; Andrea De Berardinis; Andrea Martinese; Gerard Nkamtse Tochap; Alessandro Conforti; Carlo Masciocchi Journal: Radiol Med Date: 2022-10-19 Impact factor: 6.313
Authors: I Belinchón; L Salgado-Boquete; A López-Ferrer; M Ferran; P Coto-Segura; R Rivera; D Vidal; L Rodríguez; P de la Cueva; R Queiro Journal: Actas Dermosifiliogr (Engl Ed) Date: 2020-07-10