Article
Association between nail psoriasis severity, quality life disorders and psoriatic arthritis
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Published: | September 14, 2021 |
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Introduction: Nail psoriasis has been proposed as a predictor for the development of psoriatic arthritis (PsA) and might negatively impacts on quality of life. The therapy of nail psoriasis remains a difficult problem in a real practice.
Objective: to study the prevalence of nail involvement in patients (pts) with psoriasis and its associated with PsA and quality life status.
Methods: 99 unselected pts (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. The Dermatology Life Quality Index (DLQI, 0-30) and Nail Psoriasis Severity Index (NAPSI, 0-32) were performed. The number of pts with NAPSI=0/NAPSI>0 and PsA were calculated. DLQI 2-5/6-10/11-20/21-30 corresponded to small effect/moderate effect/very large/extremely large effect on pt,s life. M±σ, %, Pirson chi², likelihood chi² were calculated. All p<0.05 were considered to indicate statistical significance.
Results: 20 out of 99 pts (20.2%) had PsA. In whole group mean NAPSI was 13.95±19.77. Nail involvement was found in 42 out of 99 pts (42.4%). PsA is found in a significantly larger number of pts with nail psoriasis compare to pts without nail involvement – in 13 out of 42 pts (31%) and in 7 out of 57 pts (12.3%) accordingly. Significant associated between nail psoriasis severity by NAPSI and PsA were found (p=0.022 for all). In whole group mean DLQI was 15.02±6.02. In pts with NAPSI>0 DLQI 2-5/6-10/11-20/21-30 were noted in 2 out of 42 pts (4.76%)/5 out of 42 pts (11.9%)/in 32 out of 42 (76.2%)/in 3 out of 42 pts (7.14%) accordingly. Significant associated between nail psoriasis severity by NAPSI and DLQI were found (Pirson chi²p=0.006 and likelihood chi² p=0.004).
Conclusion: In our real-life psoriasis pts cohort about half of them have nail psoriasis despite of different type of therapy. Severity of nail psoriasis is associated with PsA and a worse quality of life. It should be taken in account for PsA screening and making right therapy design in daily dermatological practice.
Disclosures: None declared