Chamurlieva M.N
Background: Nail psoriasis is a risk factors of psoriatic arthritis
(PsA) and might negatively impacts on quality of life. The therapy
of nail psoriasis remains a difficult problem in a real dermatological
practice.
Objective: to study the prevalence of nail involvement in patients
with severe plaque psoriasis and its associated with PsA.
Methods: 99 unselected patients (male-23/female-76) with severe
plaque psoriasis, mean age 45.82±14.04 years, BSA 56.35±9.11%,
PASI 22.50±5.13 were included. PsA was diagnosed by the
CASPAR criteria (ClASsification criteria for Psoriatic Arthritis). Nail
Psoriasis Severity Index (NAPSI, 0-32) was performed. The number
of patients with NAPSI=0/NAPSI>0 and PsA were calculated. All
patients were treated with different synthetic DMARDs, mostly
Methotrexate subcutaneous 15-20 mg/week, different biological
DMARDs according to the national guidelines. M±σ, %, Pirson
chi², likelihood chi² were calculated. All p<0.05 were considered to
indicate statistical significance.
Results: 20 out of 99 patients (20.2%) had PsA. In whole group
mean NAPSI was 13.95±19.77. Nail involvement was found in 42
out of 99 patients (42.4%). PsA is found in a significantly larger
number of patients with nail psoriasis compare to patients without
nail involvement – in 13 out of 42 patients (31%) and in 7 out of 57
patients (12.3%) accordingly. Significant associated between nail
psoriasis severity by NAPSI and PsA were found (p=0.022 for all).
Conclusion: In real clinical practice psoriasis patients cohort about
half of them have nail psoriasis despite of different type of therapy.
Severity of nail psoriasis is associated with PsA. It should be taken
in account for PsA screening and making right therapy design in
daily dermatological practice.