Distal interphalangeal joint extensor tendon enthesopathy in patients with nail psoriasis

Abstract

The aim of the study was an ultrasound assessment of distal interphalangeal (DIP) joint enthesopathy in patients with nail psoriasis. Altogether, 72 patients with nail psoriasis (41 with psoriasis and 31 with psoriatic arthritis) and 30 people in the control group participated in the study. In total, 1014 nails were examined. The thickness of DIP digital extensor tendons in the groups of patients with psoriasis (Ps) and psoriatic arthritis (PsA) was correlated with the nail bed thickness (r = 0.316, p = 0.027 vs. r = 0.402, p = 0.031, respectively) and with the thickness of the nail matrix in patients with psoriasis (r = 0.421, p = 0.012). The linear regression model showed the tendon thickness in Ps patients to be affected by the nail bed thickness, duration of psoriasis and the thickness of the nail matrix, whereas in PsA patients it was found to be significantly affected by duration of psoriasis and of arthritis, the nail bed thickness, CRP concentration and the swollen joint count. Our findings may indicate the role of the nail-tendon apparatus changes in the PsA development and they emphasise the justifiability of US examinations in patients with psoriasis direct assessment of morphological changes in nails as potential predictors of PsA development.

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“…[12][13][14][15][16][17] These findings are supported by the growing evidence for an anatomical correlation between nail psoriasis and enthesitis of the DIP joints, as a manifestation of PsA. 18,19 Besides a higher psoriasis severity, 4 a longer duration of psoriatic skin lesions is also associated with a higher frequency in nail changes. 20 The relatively long duration of disease could partly account for the high prevalence of nail changes in our population.…”

European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Position Statement on Dermatologic Ultrasound

“…Nail disease in psoriasis has been correlated with the presence of enthesopathy and psoriatic arthritis, even in the absence of clinical signs. Therefore, with clinically inconclusive signs of a psoriatic onychopathy, US may add useful information [50][51][52].…”

Serum Metabolomic Profiling Reveals the Amelioration Effect of Methotrexate on Imiquimod-Induced Psoriasis in Mouse

“…The related report indicated that one of the pathogeneses of psoriasis is hypernomic activation of toll-like receptors in dendritic cells, which is basically believed to be crucial in initiating an immune response ( Meng et al, 2017 ). To date, most studies have investigated feasible treatments for the disease, which may require the fundamental role for short-term improvement and long-term control, but there is no standardized therapeutic regimen for psoriasis and is incapable of resulting in the complete clearing of psoriasis ( Al-Suwaidan and Feldman, 2000 ; Naldi et al, 2003 ; Krajewska-Wlodarczyk et al, 2018 ).…”