title: Nail Psoriasis: A Systematic Evaluation in 313 Children with Psoriasis.
abstract: OBJECTIVE
  Little information is available on the prevalence and clinical aspects of nail involvement in children with psoriasis. The objective of this study was to evaluate the prevalence and clinical aspects of and the risk factors for nail involvement in French children with psoriasis.
  
  
  METHODS
  We performed a multicenter, cross-sectional study in 23 French dermatology centers. All children seen during the 1-year study were systematically included. Clinical features of the nails were collected. Association with clinical aspects of the disease and comorbidities were evaluated.
  
  
  RESULTS
  Of 313 children with psoriasis (mean age 9.1 ± 4.2 yrs; 149 boys, 164 girls), 31.1% had familial psoriasis and 30% had severe psoriasis. The mean age at onset was 6.1 ± 3.7 years. Nails were involved in 32.3% of children. The main clinical aspects were pitting (69.1%) for fingernails and onycholysis (40.0%) and pachyonychia (27.5%) for toenails. All of the fingers were involved at similar frequencies, whereas the big toe was involved twice as often as the others (p < 0.005). Nail involvement was associated with male sex (p < 0.001), palmoplantar psoriatic (p < 0.001), severity of disease (p = 0.003), and psoriatic arthritis (p = 0.03).
  
  
  CONCLUSIONS
  The prevalence of nail involvement was 32.3% in children with psoriasis. Clinical aspects in children are reported, as well as clinical associations. As in adults, nail psoriasis is closely associated with psoriatic arthritis.
authors.affiliation: Service de Dermatologie, Hôpital Victor Dupouy, Argenteuil, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Pourchot
authors.affiliation: Service de Dermatologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes Sorbonne Paris Cité, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Bodemer
authors.affiliation: Service de Néphro-Rhumato-Dermatologie pédiatrique, Hôpital Femme-Mère-Enfant, Bron, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Phan
authors.affiliation: Service de Dermatologie, Hôpital Brabois, Vandœuvre Les Nancy, France.
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Bursztejn
authors.affiliation: Service de Dermatologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris-Descartes Sorbonne Paris Cité, Paris, France.
authors.forename: Smaïl
authors.initials: S
authors.lastname: Hadj-Rabia
authors.affiliation: Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Enfants, Bordeaux, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Boralevi
authors.affiliation: Service de Dermatologie, Centre Hospitalier Universitaire Pontchaillou, Rennes, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Miquel
authors.affiliation: Unité de Dermatologie Infectiologie, Centre Hospitalier Intercommunal de Fréjus/Saint-Raphaël, Fréjus, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hubiche
authors.affiliation: Service de Dermatologie, Centre Hospitalier Universitaire Saint-Jacques, Besançon, France.
authors.forename: Eve
authors.initials: E
authors.lastname: Puzenat
authors.affiliation: Service de Néphro-Rhumato-Dermatologie pédiatrique, Hôpital Femme-Mère-Enfant, Bron, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Souillet
authors.affiliation: Service de Dermatologie, Centre Hospitalier de Cornouaille, Quimper, France.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kupfer
authors.affiliation: Service de Rhumatologie Pédiatrique, CeRéMAI, Université Paris Sud, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Maryam
authors.initials: M
authors.lastname: Piram
authors.affiliation: Département de Santé Publique, Assistance Publique-Hôpitaux de Paris, Centre Hospitalier Universitaire Ambroise Paré, Université Versailles-Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Beauchet
authors.affiliation: Service de Dermatologie, Hôpital Victor Dupouy, Argenteuil, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mahé
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D009260:Nail Diseases / Q000453:epidemiology*; D009262:Nails / Q000473:pathology*; D015995:Prevalence; D011565:Psoriasis / Q000453:epidemiology*; D012307:Risk Factors