title: Psoriatic Nail Changes Are Associated With Clinical Outcomes in Psoriatic Arthritis.
abstract: BACKGROUND
  Nail changes are common in psoriatic arthritis (PsA), with varying relationships existing between skin, nail, and joint disease.
  
  
  OBJECTIVE
  To further characterize relationships between nail changes, psoriasis, and joint involvement in PsA patients.
  
  
  METHODS
  One hundred eighty-eight PsA patients had skin, fingernail, and rheumatological assessments completed. Hand and fingernail photographs were taken and reviewed by a dermatologist.
  
  
  RESULTS
  Higher swollen joint counts were associated with distal interphalangeal (DIP)/periungual psoriasis (P=.001), more splinter hemorrhages (P=.006), and any nail bed change (P=.03). Higher tender joint counts were associated with rough onychorrhexis (P<.001), DIP/periungual psoriasis (P=.03), red lunula (P=.001), nail crumbling (P=.046), any nail matrix (P=.03), and nail bed change (P=.03). Joint involvement was associated with same-digit nail changes; strongest association was swollen or tender DIP with subungual hyperkeratosis, odds ratio=26.6 (95% CI, 5.1-139.1).
  
  
  CONCLUSIONS
  The DIP/periungual psoriasis and specific nail changes were associated with higher joint counts and certain nail changes with same-digit joint involvement.
authors.affiliation: Michael G. DeGroote School of Medicine, Hamilton, ON, Canada matthew.sandre@medportal.ca.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Sandre
authors.affiliation: St. Joseph's Hospital, London, ON, Canada Schulich School of Medicine, London, ON, Canada.
authors.forename: Sherry
authors.initials: S
authors.lastname: Rohekar
authors.affiliation: Schulich School of Medicine, London, ON, Canada Guenther Dermatology Research Centre, London, ON, Canada.
authors.forename: Lyn
authors.initials: L
authors.lastname: Guenther
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000175:diagnosis / Q000473:pathology*; D009262:Nails / Q000473:pathology*; D011379:Prognosis
keywords: nail changes; nails; onychopathy; psoriasis; psoriatic arthritis