Nail Psoriasis in Individuals With Psoriasis Vulgaris: A Study of 661 Patients

Armesto, S.; Esteve, A.; Coto-Segura, P.; Drake, M.; Galache, C.; Martínez-Borra, J.; Santos-Juanesc, J.

doi:10.1016/S1578-2190(11)70819-8

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Abstract

Background and objectives

The nails are affected in a substantial number of patients with psoriasis. Nevertheless, few epidemiological studies have reported the characteristics of patients with nail psoriasis. Here we describe the epidemiology of nail psoriasis and the main characteristics of affected patients.

Patients and methods

We undertook a prospective case-control study at Hospital Universitario Marqués de Valdecilla and Hospital Universitario Central de Asturias in Spain between January 2007 and December 2009.

Results

Of a total of 661 patients included, 47.4% were diagnosed with nail psoriasis, which was 13.5% more prevalent in men. The group of patients with nail disease had more severe psoriasis (12.82 vs 8.22 points on the psoriasis area and severity index) and a longer disease duration (20.30 vs 13.94 years), and included a larger percentage of patients with psoriatic arthritis (29.7% vs 11.5%), a positive family history of the disease (53.7% vs 42.8%), and a body mass index greater than 30 (31.6% vs 23.9%). A larger percentage of the patients with nail disease had early-onset psoriasis (74.1% vs 65.5%) and fewer were carriers of the human lymphocyte antigen Cw*0602 allele (33% vs 50.3%).

Conclusions

Nail disease is frequent in psoriasis and is associated with greater severity of psoriasis and a larger number of comorbidities.

Keywords:

Psoriasis

Nail

Resumen

Introducción y objetivos

La psoriasis ungueal afecta a un número importante de pacientes con psoriasis. No obstante, son raros los estudios epidemiológicos que recojan las características de estos individuos. Describimos la epidemiología y principales características de los pacientes con psoriasis ungueal.

Material y método

Se trata de un estudio prospectivo de casos y controles realizado en el Hospital Universitario Marqués de Valdecilla y Hospital Universitario Central de Asturias entre enero de 2007 y diciembre de 2009.

Resultados

De un total de 661 pacientes la psoriasis ungueal fue diagnosticada en el 47,4% de los pacientes. La prevalencia fue 13,5 puntos mayor en hombres que en mujeres. Los pacientes con afectación ungueal presentan mayor severidad de la enfermedad (PASI 12,82 vs 8,22), mayor duración de la misma (20,30 vs 13,94 años), incidencia superior de artropatía psoriática (29,7% vs 11,5%), mayor frecuencia de antecedentes familiares positivos (53,7% vs 42,8%) y mayor proporción de obesidad IMC > 30 (31,6 vs 23,9%). La psoriasis en el grupo con afectación ungueal se inicia de forma precoz (74,1 vs 65,5%) y se asocia con menor frecuencia a Cw*0602 (33 vs 50,3%).

Conclusiones

La afectación ungueal es una manifestación frecuente en los pacientes con psoriasis y se asocia a mayor gravedad de la enfermedad y mayor número de comorbilidades.

Palabras clave:

Psoriasis

Uña

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