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Journal of the American Academy of Dermatology
Volume 77, n° 5
pages 863-867 (novembre 2017)
Doi : 10.1016/j.jaad.2017.04.001
accepted : 5 April 2017
Original Articles

Nail findings in patients with psoriatic arthritis: A cross-sectional study with special reference to transverse grooves
 

Yukari Zenke, MD a, , Yuri Ohara, MD b, Daiki Kobayashi, MD, MPH c, Satoru Arai, MD, PhD a, Mitsumasa Kishimoto, MD, PhD b, Masato Okada, MD b, Hikaru Eto, MD, PhD a
a Department of Dermatology, St. Luke's International University, Tokyo, Japan 
b Immuno-Rheumatology Center, St. Luke's International University, Tokyo, Japan 
c Department of General Internal Medicine and Center for Clinical Epidemiology, St. Luke's International University, Tokyo, Japan 

Correspondence to: Yukari Zenke, MD, Department of Dermatology, St. Luke's International University, 9-1 Akashi-cho, Chuo-ku, Tokyo, Japan, 1048560.Department of DermatologySt. Luke's International University9-1 Akashi-cho, Chuo-kuTokyo1048560Japan
Abstract
Background

Patients with psoriatic arthritis (PsA) commonly present with nail manifestations; however, little is known about these manifestations.

Objective

This study investigated whether nail findings can be used to discriminate between PsA and psoriasis without arthritis.

Methods

We performed a retrospective analysis of 118 patients with PsA and 974 patients with psoriasis without arthritis who visited St. Luke's International Hospital (Tokyo, Japan) between July 2003 and February 2015. Patients with PsA were classified according to the Classification of Psoriatic Arthritis criteria. Skin lesion severity was assessed by using the Psoriasis Area and Severity Index, and 9 types of nail findings were investigated.

Results

The incidence of nail involvement in patients with PsA was 67.6%. Female sex, presence of transverse grooves, onycholysis, and splinter hemorrhages were significantly related to PsA, with transverse grooves demonstrating the strongest association (odds ratio, 5.01; 95% confidence interval, 2.31-10.8; P  < .01). Furthermore, the presence of transverse grooves was strongly related to both distal interphalangeal arthritis and enthesitis.

Limitations

The PsA population was relatively small.

Conclusions

Nail findings enabled us to distinguish patients with PsA from those without arthritis. The presence of transverse grooves is significantly associated with PsA and may be associated with distal interphalangeal arthritis and enthesitis.

The full text of this article is available in PDF format.

Key words : enthesitis, nail, onycholysis, psoriatic arthritis, splinter hemorrhage, transverse grooves

Abbreviations used : CI, DIP, NAPSI, OR, PASI, PsA, Pso



 Funding sources: None.
 Conflicts of interest: None declared.
 Reprints not available from the authors.



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