Nail psoriasis as a predictor of the development of psoriatic arthritis

Raposo, Inês; Torres, Tiago

doi:10.1016/j.ad.2015.02.005

Cited by 69 publications

(49 citation statements)

References 38 publications

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“…125–138 The prevalence of PsA increases with greater psoriasis severity 125,133,139 and duration, 125,140 however, the severity of skin disease is only weakly associated with severity of joint disease. PsA has been associated with the distribution of psoriasis involvement (i.e., scalp, intergluteal, perianal) 141 and the presence of nail dystrophy, which is suggested to indicate early enthesial inflammation 124,141,142 .…”

Section: Psoriatic Arthritismentioning

confidence: 99%

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Psoriasis and comorbid diseases

Takeshita

Grewal

Langan

et al. 2017

Journal of the American Academy of Dermatology

866

703

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Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic disease, gastrointestinal disease, kidney disease, malignancies, infections, and mood disorders. The pathogenesis of comorbid disease in psoriasis patients remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of healthcare providers is essential to ensuring comprehensive medical care for patients with psoriasis.

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Section: Psoriatic Arthritismentioning

confidence: 99%

“…Undiagnosed PsA among psoriasis patients seen in the dermatology setting is prevalent and estimated at 15.5%. 148 PsA generally occurs after the onset of psoriasis 142,148 and can be progressive and result in permanent joint damage. Therefore, early detection is essential as early treatment improves outcomes.…”

Section: Psoriatic Arthritismentioning

confidence: 99%

Psoriasis and comorbid diseases

Takeshita

Grewal

Langan

et al. 2017

Journal of the American Academy of Dermatology

866

703

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“…Psoriatic arthritis (PsA) develops in 7–26% of those with psoriasis vulgaris [7, 19]. The presence of skin lesions precedes articular symptoms typical of PsA in 75–80% of patients with a mean estimated delay of 10 years [20].…”

Section: The Correlation Between Different Manifestations Of Psoriasismentioning

confidence: 99%

“…The presence of skin lesions precedes articular symptoms typical of PsA in 75–80% of patients with a mean estimated delay of 10 years [20]. However, nail changes are observed in 40% of psoriasis patients and up to 80% of those with PsA [21]. This fact became the basis for numerous studies exploring the relationship of nail psoriasis and inflammatory changes in joints.…”

Section: The Correlation Between Different Manifestations Of Psoriasismentioning

confidence: 99%

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Nail involvement in psoriatic arthritis

Sobolewski¹,

Walecka²,

Dopytalska³

2017

Reumatologia

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Nail psoriasis is considered a significant psychological and social problem causing functional impairment in affected patients. Nail changes hamper their daily and occupational activities and contribute to a worse quality of life. Almost 50% of patients with psoriasis vulgaris and up to 80% of patients with psoriatic arthritis are afflicted with nail lesions. The important correlation between psoriatic arthritis and nail changes is well established – the presence of the latter is a strong predictor of the development of arthritis. There is a broad spectrum of nail dystrophies associated with psoriasis, ranging from the common pitting, subungual hyperkeratosis and loosening of the nail plate to less frequent discolouration and splinter haemorrhages. Some of these symptoms are also observed in other nail diseases, and further diagnostics should be performed. The assessment tools NAPSI (Nail Psoriasis Severity Index), mNAPSI (Modified Nail Psoriasis Severity Index), and PNSS (Psoriasis Nail Severity Score) are most commonly used to grade the severity of nail involvement in psoriasis and enable the evaluation of therapy effectiveness. The treatment of nail psoriasis is a major clinical challenge. It should be adjusted to the extent of dermal, articular and ungual lesions. Systemic therapies of psoriasis, especially biological agents, are most likely to be effective in treating nail psoriasis. However, as their use is limited in scope and safety, topical therapy remains a mainstay, and the combination of corticosteroids and vitamin D3 analogues is considered to be most helpful.

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