title: Nail involvement in systemic sclerosis.
abstract: BACKGROUND
  Nail involvement has rarely been recognized in systemic sclerosis (SSc). Indeed, only a few small series have assessed nail changes in SSc, most of which are case reports.
  
  
  OBJECTIVE
  The aims of the current case-control study were to: (1) determine the prevalence of fingernail changes in SSc; and (2) evaluate the correlation between fingernail changes and other features of SSc.
  
  
  METHODS
  In all, 129 patients with SSc and 80 healthy control subjects underwent routine fingernail examination.
  
  
  RESULTS
  The prevalence of fingernail changes was 80.6% in SSc. Patients with SSc more frequently exhibited: trachyonychia (P = .006), scleronychia (P < .0001), thickened nails (P < .0001), brachyonychia (P = .0004), parrot beaking (P < .0001), pterygium inversum unguis (P < .0001), splinter hemorrhages (P < .0001), and cuticle abnormalities (P < .0001) than healthy control subjects. The presence of fingernail changes was associated with digital ulcers (P < .0001), calcinosis cutis (P = .004), and higher values of mean nailfold videocapillaroscopy score (P = .0009).
  
  
  CONCLUSIONS
  The cohort originated from a single center.
  
  
  CONCLUSIONS
  This study underlines that fingernail changes are correlated with more severe forms of SSc characterized by digital microangiopathy, including digital ulcers and calcinosis cutis. Nail changes should be systematically checked in all patients with SSc, and may be included in the American College of Rheumatology/European League Against Rheumatism classification criteria for SSc.
authors.affiliation: Department of Internal Medicine, Rouen University Hospital, Rouen, France; Institut National de la Santé et de la Recherche Médicale U 905, University of Rouen Institut Fédératif Multidisciplinaire sur les Peptides, Institute for Biochemical Research, Rouen, France. Electronic address: isabelle.marie@chu-rouen.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Marie
authors.affiliation: Department of Internal Medicine, Rouen University Hospital, Rouen, France; Institut National de la Santé et de la Recherche Médicale U 905, University of Rouen Institut Fédératif Multidisciplinaire sur les Peptides, Institute for Biochemical Research, Rouen, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gremain
authors.affiliation: Department of Internal Medicine, Rouen University Hospital, Rouen, France; Institut National de la Santé et de la Recherche Médicale U 905, University of Rouen Institut Fédératif Multidisciplinaire sur les Peptides, Institute for Biochemical Research, Rouen, France.
authors.forename: Kladoum
authors.initials: K
authors.lastname: Nassermadji
authors.affiliation: Department of Internal Medicine, Rouen University Hospital, Rouen, France; Institut National de la Santé et de la Recherche Médicale U 905, University of Rouen Institut Fédératif Multidisciplinaire sur les Peptides, Institute for Biochemical Research, Rouen, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Richard
authors.affiliation: Department of Dermatology, Rouen University Hospital, Rouen, France; Institut National de la Santé et de la Recherche Médicale U 905, University of Rouen Institut Fédératif Multidisciplinaire sur les Peptides, Institute for Biochemical Research, Rouen, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Joly
authors.affiliation: Department of Biostatistics, Rouen University Hospital, Rouen, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Menard
authors.affiliation: Department of Internal Medicine, Rouen University Hospital, Rouen, France; Institut National de la Santé et de la Recherche Médicale U 905, University of Rouen Institut Fédératif Multidisciplinaire sur les Peptides, Institute for Biochemical Research, Rouen, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Levesque
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D012595:Scleroderma, Systemic / Q000150:complications*; D055815:Young Adult
keywords: diagnosis; digital ulcers; nail involvement; predictive factor; systemic sclerosis