In the Journals

Psoriasis, psoriatic arthritis patients displayed nail abnormalities

Patients with psoriatic arthritis and those with cutaneous psoriasis displayed abnormalities of the ventral nail plate when examined with ultrasound and power Doppler, according to recent study results.

Researchers in Argentina studied 35 patients with psoriatic arthritis (PsA; mean age, 51 years), 20 with cutaneous psoriasis (mean age, 49 years), 27 with rheumatoid arthritis (RA; mean age, 55 years) and 28 controls (mean age, 47 years). Nails on both hands were examined, and ventral and dorsal nail plate morphologic abnormalities were classified. Researchers also measured distance between ventral plate and bone margin of the distal phalanx at the right index finger.

Ultrasound (US) imaging showed that all patients and controls displayed abnormalities. A higher number of compromised nails (at least seven nails) was evident in patients with PsA and psoriasis compared with patients with RA and the controls (three or fewer nails.). When measured with Wortsman typology, patients with PsA showed type II persistence (loosening of the borders of the ventral plate), while patients with psoriasis displayed type I persistence (focal hyperechoic involvement of the ventral plate without dorsal plate involvement). Nineteen patients with PsA and 10 patients with cutaneous psoriasis did not display clinical nail alterations; however, US detected type II and type I alterations in the groups, respectively.

Power Doppler (PD) increases in distal interphalangeal joints and nail beds were significant in patients with psoriatic arthropathy (P=.0001). Patients with PsA (P<.001) and those with cutaneous psoriasis (P=.005) had a significant difference between the mean distance ventral plate-osseous margin of the distal phalanx compared with RA patients (P=.548).

“Abnormalities of the ventral plate in nails were seen as a predominant feature in PsA as well as in patients with cutaneous psoriasis,” the researchers concluded. “This presentation provides evidence that high-resolution gray-scale sonography with PD imaging is a real-time and noninvasive imaging technique that can be used as an adjunct to clinical evaluation in psoriatic disease.”

Disclosure: The researchers report no relevant financial disclosures.