Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails

Abstract

The link between nail disease and contemporaneous subclinical enthesopathy offers a novel anatomical basis for the predictive value of nail psoriasis for PsA evolution.

Subclinical enthesopathy in patients with psoriasis and its association with other disease parameters: a power Doppler ultrasonographic study

“…In this study, we found a significant correlation between the disease duration and US enthesitis, which is consistent with that reported by Ozcakar et al (8) in their study on US of the Achilles tendon in patients with psoriasis and Ash et al (23) who examined the association between nail changes and subclinical enthesitis. This was contrary to that reported by Naredo et al (19) and Gutierrez et al (21).…”

Enthesopathy and the Cutaneous Disease Activities in Psoriatic Arthritis

“…Specifically, enthesitis is associated with adjacent osteitis or bone and synovial inflammation. Moreover, Ash ZR et al [35] demonstrated that enthesopathy scores were higher in patients with psoriatic nail disease than in patients without nail disease and healthy controls. In contrast to our results, Ash ZR et al [35] showed that no link between the psoriasis area and severity index and enthesitis was evident.…”

“…Moreover, Ash ZR et al [35] demonstrated that enthesopathy scores were higher in patients with psoriatic nail disease than in patients without nail disease and healthy controls. In contrast to our results, Ash ZR et al [35] showed that no link between the psoriasis area and severity index and enthesitis was evident. A possible Explanation of differences of correlation between enthesitis scores and severity of psoriasis from other authors may be due different methods of assessment of enthesopathy and severity of psoriasis as well as our patients had moderate-to-severe PsA.…”

Ultrasonography in psoriatic disease

“…Due to the close anatomic connection between the nails and extensor digitorum tendon attachment to the bone and the periosteum, the higher prevalence of nail involvement in patients with psoriatic arthritis could be explained [42]. Recent studies underlined the existence of a link between nail psoriasis and synovio-entheseal complex in psoriatic arthritis [43][44][45].…”