title: Nail involvement can predict enthesopathy in patients with psoriasis.
abstract: BACKGROUND
  Although subclinical enthesopathy is a well-established diagnostic criterion for psoriatic arthritis (PsA), it is frequently overlooked, as many patients are asymptomatic. The possibility of finding a clinical clue predicting enthesopathy would help clinicians establish an early diagnosis of PsA.
  
  
  METHODS
  A prospective single-center study of a total of 90 patients with psoriasis was conducted to assess the presence of entheseal abnormalities as detected by ultrasound, and to determine any correlation with nail involvement.
  
  
  RESULTS
  Entheseal abnormalities were found in 23 patients (25.5 %), 19 (82.6 %) of whom showed nail involvement, whereas four (17.4 %) individuals did not. Enthesopathy was present in 31.1 % (19/61) of patients with onychopathy compared to 13.8 % (4/29) of those without nail involvement (p  =  0.07). There was a significant correlation between target NAPSI score and evidence of enthesopathy. In addition, the number of nails affected also showed a significant correlation with the presence of enthesopathy (p  = 0.035).
  
  
  CONCLUSIONS
  Clinical evidence of onychopathy may be the clue to an early diagnosis of enthesopathy in psoriasis patients.
authors.affiliation: Department of Dermatology and Venereology, Hospital Universitario, 12 de Octubre, Madrid, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Castellanos-González
authors.affiliation: Department of Rheumatology, Hospital Universitario, 12 de Octubre, Madrid, Spain.
authors.forename: Beatriz Esther
authors.initials: BE
authors.lastname: Joven
authors.affiliation: Department of Rheumatology, Hospital Universitario, 12 de Octubre, Madrid, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Sánchez
authors.affiliation: Research Unit, Clinical, Epidemiology and Public Health CIBER, Hospital Universitario, 12 de Octubre, Madrid, Spain.
authors.forename: Eva María
authors.initials: EM
authors.lastname: Andrés-Esteban
authors.affiliation: Department of Dermatology and Venereology, Hospital Universitario, 12 de Octubre, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Vanaclocha-Sebastián
authors.affiliation: Department of Dermatology and Venereology, Hospital Universitario, 12 de Octubre, Madrid, Spain.
authors.forename: Pablo Ortiz
authors.initials: PO
authors.lastname: Romero
authors.affiliation: Department of Dermatology and Venereology, Hospital Universitario, 12 de Octubre, Madrid, Spain.
authors.forename: Raquel Rivera
authors.initials: RR
authors.lastname: Díaz
mesh_terms: D017677:Age Distribution; D015897:Comorbidity; D042241:Early Diagnosis; D000070676:Enthesopathy / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D011565:Psoriasis / Q000175:diagnosis* / Q000453:epidemiology*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology