title: Optical coherence tomography: a new tool to assess nail disease in psoriasis?
abstract: BACKGROUND
  Nail disease is a characteristic manifestation of the psoriatic disease spectrum but is poorly understood.
  
  
  OBJECTIVE
  Given the intrinsically high spatial resolution imaging capabilities of optical coherence tomography (OCT), we assessed its value in psoriatic nail disease compared to high-resolution ultrasonography (US).
  
  
  METHODS
  All fingernails in a psoriatic arthritis patient with nail changes were scanned with OCT, and findings were compared with high-resolution US.
  
  
  RESULTS
  US showed loss of trilaminar appearance in all nails, resulting in the nail plate being visualized as a single hyperechoic layer with inhomogeneous thickness. The OCT images showed much higher-resolution changes with prominent thickening in the ventral plate at the nail bed which was grossly inhomogeneous, 'eroded' and irregularly fused with the underlying epidermis, which correlated with the clinical observation of subungal hyperakeratosis.
  
  
  CONCLUSIONS
  OCT has considerable potential for the evaluation of psoriatic nail disease and may be superior to US.
authors.affiliation: NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK. drsibelaydin@gmail.com
authors.forename: Sibel Zehra
authors.initials: SZ
authors.lastname: Aydin
authors.forename: Zoe
authors.initials: Z
authors.lastname: Ash
authors.forename: Francesco
authors.initials: F
authors.lastname: Del Galdo
authors.forename: Helena
authors.initials: H
authors.lastname: Marzo-Ortega
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wakefield
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
authors.forename: Dennis
authors.initials: D
authors.lastname: McGonagle
mesh_terms: D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D009260:Nail Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D041623:Tomography, Optical Coherence; D014463:Ultrasonography
chemical_list: D003879:Dermatologic Agents; D007052:Ibuprofen; D008727:Methotrexate