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.
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 February 18, 2020.
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