Nail Abnormalities, Quality of Life and Serum Inflammatory Marker in Psoriatic Arthritis Compare to Psoriasis Without Arthritis
Rujikan Ausavarungnirun MD*, Julphat Intarasupht MD*, Artit Nakakes MD*, Kajohn Rojanametin MD*
Affiliation : * Division of Dermatology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
Background : The prevalence of nail abnormality in psoriasis is 15 to 50%. The rate is increased in psoriatic arthritis.
Objective : To study the nail abnormalities quality of life and serum inflammatory marker in psoriasis patients in relation
to psoriatic arthritis.
Material and Method: A case-control study was performed at Phramongkutklao Hospital between January 1 and October
31, 2013. The demographic data and laboratory investigations of 55 cases of psoriasis patients with and without arthritis
were compared.
Results : Psoriasis patients with arthritis had more nail abnormalities than those without (43 vs. 29, p-value = 0.005). The
most common type of nail involvement was onycholysis. Quality of life in psoriasis patients with arthritis was worse than
those without (visual analog score 50.24±23.13 vs.20.77±17.33, p-value <0.001). Nail involvement, ESR 37 mm/hour or
more and hs-CRP 2.94 mg/dL or more were associated with arthritis in psoriasis (sensitivity 74.55%, specificity 58.18%,
and area under curve 0.7286, and sensitivity 69.09%, specificity 60.00%, and area under curve 0.682 for ESR and hs-CRP
respectively).
Conclusion : Psoriatic arthritis has more nail abnormalities. Arthritis is associated with worse quality of life in psoriasis.
Nail abnormalities, ESR 37 mm/hour or more and hs-CRP 2.94 mg/dL or greater may predict arthritis in psoriasis patients.
Keywords : Psoriasis, Arthritis, Nail abnormalities, ESR, hs-CRP
