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DOI 10.1007/s10067-006-0476-y
ORIGINAL ARTICLE
Received: 29 September 2006 / Revised: 18 October 2006 / Accepted: 19 October 2006 / Published online: 22 November 2006
# Clinical Rheumatology 2006
positive correlation was also determined between fingerand toenail psoriasis severity and bone involvement
severity (r=0.379, p=0.001 and r=0.288, p=0.015).
Keywords Bone . Distal interphalangeal . Erosions . Nail .
Psoriasis . Psoriatic arthritis
Introduction
Psoriatic nail involvement is a common finding of psoriasis,
and in many patients, both the matrix and nail involvement
is present. At least 70% of patients with psoriatic arthritis
(PsA) have nail changes [1]. In previous studies, association between nail involvement and joint manifestations
have been studied. Distal interphalangeal (DIP) joint
involvement associated with nail dystrophy in PsA has
been shown by Jones et al. [2]. Patients with more severe
nail disease have worse skin disease and higher rates of
unremitting and progressive arthritis with associated functional impairment [3].
However, the relationship between joint, bone and nail
psoriasis in patients without PsA has not been reported
previously. We aimed to investigate the relationship
between the nail involvement and bone and joint manifestations and whether there was a correlation between nail
psoriasis severity and bone involvement severity in psoriatic patients without PsA.
1246
Results
Thirty-one psoriasis patients with nail involvement (16 men
and 15 women, mean age 45.2918.73; group I) and 39
Fingernail
Toenail
Involved
Not involved
Involved
Not involved
Tuft (+)
Tuft ()
p value
17
19
10
10
8
26
11
39
0.039
0.021
Discussion
In this study, we determined that (1) DIP involvement was
present in the two groups regardless of nail involvement,
(2) bone involvement was higher in patients with nail
involvement than patients without nail involvement, and (3)
there was a correlation between nail psoriasis severity and
bone involvement severity.
The inflammatory process of PsA in the peripheral joints
can induce bone damage without clinical signs of arthritis
or a very recent onset of the symptomatic disease [6]. DIP
Table 3 DIP involvement in patients with and without finger- and
toenail involvement
Toenail (n)
18
4
3
20
1
Fingernail
Mild
Moderate
Severe
Toenail
Involved
Not involved
Involved
Not involved
DIP (+)
DIP ()
p value
5
2
2
2
20
43
19
47
0.089
0.578
1247
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