title: Nail involvement in adult patients with plaque-type psoriasis: prevalence and clinical features.
abstract: BACKGROUND
  Psoriasis is a disease of worldwide distribution with a prevalence of 1 to 3%. Nail psoriasis is estimated in 50% of patients with psoriasis, and in the presence of joint involvement, it can reach 80%.
  
  
  OBJECTIVE
  To study the nail changes - and their clinical implications - presented by patients with psoriasis vulgaris under surveillance in a university hospital from the south of Brazil.
  
  
  METHODS
  his cross-sectional study evaluated 65 adult patients from January 2012 to March 2013. Cutaneous severity was assessed according to the Psoriasis Area and Severity Index (PASI). The Nail Psoriasis Severity Index (NAPSI) was used to evaluate patient's nails. The diagnosis of psoriatic arthritis was established according to the Classification Criteria for Psoriatic Arthritis (CASPAR).
  
  
  RESULTS
  The prevalence of NP was 46.1%. These patients had a median [interquartilic range (IQR)] NAPSI of 1 (0-15). A total of 63.3% of patients reported aesthetic discomfort or functional impairment related to their nails. Onycholysis was the most common feature (80%). When compared with patients without nail involvement, patients with NP had lower mean age at psoriasis onset [21 (18-41) vs. 43 (30-56) years, p=0,001]; longer disease duration [15.5 (10-24) vs. 6 (2-12) years, p=0.001]; higher PASI [9.2 (5-17) vs. 3.7 (2-10), p=0.044], higher frequency of psoriatic arthritis (43.3 vs. 3.7, p = 0.002) and more often reported family history of psoriasis (40% vs. 7.4%, p = 0.011).
  
  
  CONCLUSIONS
  Onycholysis was the most frequent finding and most patients feel uncomfortable with the psoriatic nail changes that they experience.
authors.affiliation: Universidade de Passo Fundo, Passo Fundo, RS, Brazil.
authors.forename: Karen Regina Rosso
authors.initials: KR
authors.lastname: Schons
authors.affiliation: Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
authors.forename: André Avelino Costa
authors.initials: AA
authors.lastname: Beber
authors.affiliation: Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Maristela de Oliveira
authors.initials: Mde O
authors.lastname: Beck
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Odirlei André
authors.initials: OA
authors.lastname: Monticielo
mesh_terms: D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000453:epidemiology* / Q000473:pathology*; D009262:Nails / Q000473:pathology; D011565:Psoriasis / Q000453:epidemiology* / Q000473:pathology*; D012720:Severity of Illness Index; D017678:Sex Distribution