ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2739

Subclinical Ungueal Distrophy in Patients with Psoriasis without Joint Involvement: Is There Any Role for Nail Ultrasound?

Barbara Nascimento de Carvalho Klemz1, Karine Luz2, Eugenia Maria Damasio Ohe3, Adriana Maria Porro4, Polianna de Oliveira Matos Soares5, Helder Henrique da Costa Pinheiro6 and Marcelo Pinheiro7, 1Rheumatology Division, Federal University of Sao Paulo (Unifesp/ EPM), Sao Paulo, Brazil, 2Rheumatology Division, Universidade Federal de São Paulo, São Paulo, Brazil, 3Dermatology Division, Federal University of Sao Paulo, (UNIFESP/EPM), Sao Paulo, Brazil, 4Dermatology Division, Federal University of Sao Paulo (UNIFESP/EPM), Sao Paulo, Brazil, 5Federal University of Sao Paulo (UNIFESP/EPM), Sao Paulo, Brazil, 6Federal University of Para (UFPA), Belem, Brazil, 7Federal University of São Paulo, São Paulo, Brazil

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , ,

Session Information

Date: Tuesday, November 15, 2016

Title: Spondylarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment - Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:  The joint involvement is observed in approximately 30% of patients with psoriasis (Ps). However, no clinical, lab or by imaging strategy is well established to identify them before progression to psoriatic arthritis (PsA). Purpose: To assess the association among the nail involvement and distal interphalangeal extensor enthesopathy (DIP-ExE), evaluated by ultrasound (US), with the subclinical joint involvement, including arthritis, enthesitis and dactylitis in patients with Ps.

Methods:  A total of 89 patients with active Ps were included in this cross-sectional study and were compared with 21 healthy controls, paired for sex, age and ethnicity. After evaluation by a dermatologist, including the PASE and the PEST questionnaires, as well as PASI, BSA and NAPSI, the patients were classified in two groups, according to clinical nail involvement (CNI). Moreover, they were also evaluated by a rheumatologist, regarding enthesitis, dactylitis, axial complaints and peripheral arthritis, in order to apply the CASPAR criteria (2006). A third-blind physician performed a global and complete US evaluation, including 1246 enthesis, synovial thickness in 1958 joints, 1 active skin lesion and 2 bed-nails, according to OMERACT (2010), using the MyLab60® (Esaote, Italy). P<0.05 was set as statistically significant.

Results:  There was no significant difference concerning time of disease, comorbidities, life habits and PASE in patients with CNI when compared to those no nail distrophy. However, patients with CNI (67.4%) had higher number of tender and swollen joints. The presence of nail power-Doppler (N-PwD) and the DIP-ExE was observed in 65-70% of patients with CNI (p=0.035). The nail US identified 58.6% of subclinical nail dystrophy and 70.6% had also positive N-PwD (p<0.001).

Conclusion:  Our results showed that the nail US was able to identify subclinical nail dystrophy and DIP-ExE in almost 60% of patients with active Ps, but no nail or joint clinical involvement, suggesting that it could be used for early screening of patients with increased risk of developing PsA.

Disclosure: B. Nascimento de Carvalho Klemz, None; K. Luz, None; E. Maria Damasio Ohe, None; A. Maria Porro, None; P. de Oliveira Matos Soares, None; H. Henrique da Costa Pinheiro, None; M. Pinheiro, None.

To cite this abstract in AMA style:

Nascimento de Carvalho Klemz B, Luz K, Maria Damasio Ohe E, Maria Porro A, de Oliveira Matos Soares P, Henrique da Costa Pinheiro H, Pinheiro M. Subclinical Ungueal Distrophy in Patients with Psoriasis without Joint Involvement: Is There Any Role for Nail Ultrasound? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/subclinical-ungueal-distrophy-in-patients-with-psoriasis-without-joint-involvement-is-there-any-role-for-nail-ultrasound/. Accessed .

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