title: Potential use of optical coherence tomography and high-frequency ultrasound for the assessment of nail disease in psoriasis and psoriatic arthritis.
abstract: OBJECTIVE
  Psoriatic nail disease is increasingly recognised to be of major clinical and research relevance. Clinical assessment remains the current gold standard for its evaluation.
  
  
  OBJECTIVE
  We compared optical coherence tomography (OCT) and ultrasound (US) for nail disease assessment in psoriatic disease.
  
  
  METHODS
  18 patients with at least one involved nail and 12 healthy controls were scanned using OCT; psoriatic patients also had an US scan (using a linear probe at 9-14 MHz). Nail and contour abnormalities were documented. Clinical onychopathy was scored independently using the modified Nail Psoriasis Severity Index.
  
  
  RESULTS
  Among 180 nails, 67.8% had clinical findings whereas 33.9% were abnormal by US and 44.4% had abnormalities on OCT. A positive OCT had a sensitivity and specificity of 44.4 and 95.8%, respectively, with a positive likelihood ratio of 10.7 for nail disease. OCT demonstrated 76.3% absolute agreement compared with clinical assessment and 65% with US. OCT detected subtle abnormalities in 12 clinically normal nails and in 41 nails with normal US findings.
  
  
  CONCLUSIONS
  These findings show that OCT has a potential for the systematic characterisation of psoriatic nail changes and could be useful in diagnosis and more objective assessment of treatment response.
authors.affiliation: Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Sibel Z
authors.initials: SZ
authors.lastname: Aydin
authors.forename: Concepción
authors.initials: C
authors.lastname: Castillo-Gallego
authors.forename: Zoe R
authors.initials: ZR
authors.lastname: Ash
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Abignano
authors.forename: Helena
authors.initials: H
authors.lastname: Marzo-Ortega
authors.forename: Miriam
authors.initials: M
authors.lastname: Wittmann
authors.forename: Francesco
authors.initials: F
authors.lastname: Del Galdo
authors.forename: Dennis
authors.initials: D
authors.lastname: McGonagle
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000150:complications*; D016022:Case-Control Studies; D006801:Humans; D009260:Nail Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D055815:Young Adult