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This study evaluates the fingernail findings of the rheumatoid arthritis, spondylopathy and psoriatic arthritis patient groups with the fingernails of psoriasis patients clinically and dermatoscopically and investigates the benefit of dermoscopy in the differentiation of these patients.
Psoriasis is a common chronic inflammatory disease with many comorbidities. Dermatologists have a very important role in the early diagnosis of psoriatic arthritis, which is one of the most important comorbidities of psoriasis. Therefore, studies have been conducted on many factors predicting the risk of psoriatic arthritis and it has been concluded that nail involvement is closely related to psoriatic arthritis.For this reason, the importance of nail examination in the follow-up of psoriasis patients has increased significantly. Nail examination should be done carefully to predict the risk of developing psoriatic arthritis, especially at the beginning of the disease and subclinical types, and dermoscopy should be used to identify patients who may be clinically uncertain.
In addition, rheumatoid arthritis and spondylopathy patients have a lot in common with psoriatic arthritis patients.In these patients, there is no clear distinction to diagnose joint involvement, and their distinction is mostly based on the presence or absence of skin findings.Nail findings have an important place among this skin findings in the diagnosis of these patients.
Based on all these, this study questions the benefit of clinical and dermoscopic examination of nail findings in the early stages to differentiate these patients, as well as comparing the nail findings and revealing the differences and similarities.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| rheumatoid arthritis patient | Skin and fingernail examination of newly diagnosed (diagnosed before 1 year) rheumatoid arthritis patients will be done. A detailed dermoscopic examination will be performed on the nails of these patients. |
| |
| patients with spondylopathy | Skin and fingernail examination of newly diagnosed (diagnosed before 1 year) patient with spondylopathy will be done. A detailed dermoscopic examination will be performed on the nails of these patients. |
| |
| psoriatic arthritis | Skin and fingernail examination of patient with psoriatic arthritis will be done. A detailed dermoscopic examination will be performed on the nails of these patients. PASI and NAPSI scores of all patients will be calculated. |
| |
| psoriasis patients without joint involvement | Skin and fingernail examination of patient with psoriasis patients without joint involvement will be done. A detailed dermoscopic examination will be performed on the nails of these patients. PASI and NAPSI scores of all patients will be calculated. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dermoscopic examination | Diagnostic Test | The periungual area, nail plate, subungual area of the patients' fingernails will be examined and images of the lesional nails or target nails will be recorded for comparison. |
| Measure | Description | Time Frame |
|---|---|---|
| Comparation of clinical features of nails | All of patients' fingernails will be examined clinically and visible nail findings will be noted. Many findings such as onycholysis, pitting, splinter hemorrhage, nail base vascularity, leukonychia etc. will be recorded. Also, the severity of nail involvement in psoriasis patients will be measured by the NAPSI score | six months |
| Comparation of dermoscopic features of nails | All of patients' fingernails will be examined by dermoscopy and nail findings will be noted. Also in particular, vascularization around the nail will be checked and images of all of the findings will be taken. Rheumatoid arthritis and spondylopathy patients with nail findings consistent with psoriasis will be enrolled. | six months |
| NAPSI (Psoriasis Area and Severity index) | All psoriasis patients will be scored on their nails with NAPSI (Psoriasis Area and Severity Index) scoring system. The correlation of PASI and NAPSI will be examined. | six months |
| PASI (Psoriasis Area and Severity Index) | Skin lesions of all psoriasis patients will be scored with the PASI (Psoriasis Area and Severity Index) system. The correlation of PASI and NAPSI will be examined. | six months |
| Measure | Description | Time Frame |
|---|---|---|
| Demographic characteristics | Demographic characteristics of patients will be compared. | through study completion, an average of 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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Patients over 18 years with psoriasis, rheumatoid arthritis, ankylosing spondylitis
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| Name | Affiliation | Role |
|---|---|---|
| Nahide MD Onsun, Prof | Bezmialem University | Study Director |
| Begüm MD Güneş | Bezmialem University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bezmialem Vakıf Univesity | Istanbul | 34093 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28286468 | Result | Yorulmaz A, Artuz F. A study of dermoscopic features of nail psoriasis. Postepy Dermatol Alergol. 2017 Feb;34(1):28-35. doi: 10.5114/ada.2017.65618. Epub 2017 Feb 7. | |
| 32055506 | Result | Wanniang N, Navya A, Pai V, Ghodge R. Comparative Study of Clinical and Dermoscopic Features in Nail Psoriasis. Indian Dermatol Online J. 2020 Jan 13;11(1):35-40. doi: 10.4103/idoj.IDOJ_51_19. eCollection 2020 Jan-Feb. |
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| 29449498 | Result | Zabotti A, Errichetti E, Zuliani F, Quartuccio L, Sacco S, Stinco G, De Vita S. Early Psoriatic Arthritis Versus Early Seronegative Rheumatoid Arthritis: Role of Dermoscopy Combined with Ultrasonography for Differential Diagnosis. J Rheumatol. 2018 May;45(5):648-654. doi: 10.3899/jrheum.170962. Epub 2018 Feb 15. |
| ID | Term |
|---|---|
| D015535 | Arthritis, Psoriatic |
| D001172 | Arthritis, Rheumatoid |
| D025242 | Spondylarthropathies |
| D011565 | Psoriasis |
| ID | Term |
|---|---|
| D025241 | Spondylarthritis |
| D013166 | Spondylitis |
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D017444 | Skin Diseases, Papulosquamous |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D012216 | Rheumatic Diseases |
| D003240 | Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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