Chamurlieva M N, Korotaeva T V
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.