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Assessment of nail unit structures by ultrasound in patients with psoriatic arthritis and their correlations with disease activity indices: a case–control study

  • Observational Research
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Abstract

Ultrasound (USG) of nail was performed to assess, (1) morphological alterations of nail plates in psoriatic arthritis (PsA) patients, (2) differences of nail unit parameters [nail bed thickness (NBT), nail matrix thickness (NMT) and nail plate distance (NPD)] in PsA patients from healthy controls (3) correlation of nail unit parameters with PsA disease activity indices. Total of 895 fingernails (448 nails of 45 PsA patients and 447 of 45 controls) were evaluated by USG. Psoriasis Area and Severity Index (PASI), Disease Activity in Psoriatic Arthritis (DAPSA), and Nail Psoriasis Severity Index (NAPSI) were calculated in PsA patients. Nail unit parameters were compared between two study groups. Correlation study was done between nail unit parameters and disease activity indices. All PsA patients showed ultrasound evidence of nail plate changes (87.95% of the total fingernails and 75.34% of the clinically normal nails). Loosening of the ventral nail plate border was most common (51.79%). Mean NBT (PsA: 0.19 ± 0.035 cm, control: 0.17 ± 0.018 cm, p = 0.003) and mean NMT (PsA: 0.32 ± 0.041 cm, control: 0.28 ± 0.031 cm, p = < 0.0001) were significantly increased in the PsA patients. Moderately positive correlation was observed between NAPSI score and mean NMT (Spearman r = 0.411, 95% confidence interval: 0.125–0.634, p = 0.005). USG evidence of nail plate alterations was frequent among PsA patients, even in clinically normal nails. Increased mean nail bed and matrix thickness were noted in PsA patients. Mean NMT had a moderately positive correlation with NAPSI score.

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Acknowledgements

We would like to convey our gratitude to Professor Dr. Avijit Hazra, Department of Pharmacology, Institute of Post Graduate Medical Education and Research. Kolkata, for his invaluable contribution to the statistical analysis of this study.

Funding

No financial support was taken for this study.

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Authors and Affiliations

  1. Department of Rheumatology, Institute of Post Graduate Medical Education and Research, Doctor’s hostel. 242 A J C Bose Road, Kolkata, West Bengal, 700020, India

    Sumantro Mondal, Satarupa Dutta, Debasish Lahiri, Debanjali Sinha, Geetabali Sircar & Alakendu Ghosh

  2. Department of Dermatology, Institute of Post Graduate Medical Education and Research, Kolkata, India

    Ashok Kumar Mandal & Megha Kejriwal

Authors
  1. Sumantro Mondal
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  2. Satarupa Dutta
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  3. Debasish Lahiri
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  4. Debanjali Sinha
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  5. Geetabali Sircar
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  6. Ashok Kumar Mandal
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  7. Megha Kejriwal
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  8. Alakendu Ghosh
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Contributions

All the authors have fulfilled the authorship criteria as per ICMJE 4 recommendation (1. Substantial contributions to the conception or design of the work; acquisition, analysis, or interpretation of data for the work, 2. Drafting the work or revising it critically for important intellectual content, 3. Final approval of the version to be published, 4. Agreement to be accountable for all aspects of the work).

Corresponding author

Correspondence to Sumantro Mondal.

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Conflict of interest

Sumantro Mondal, Satarupa Dutta, Debasish Lahiri, Debanjali Sinha, Geetabali Sircar, Ashok Kumar Mandal, Megha Kejriwal, and Alakendu Ghosh declare that they have no conflict of interest.

Ethical approval

Necessary approval was taken from the Research Oversight Committee (Institutional Ethics Committee) of the Institute of Post Graduate Medical Education and Research, Kolkata, India. This study was in compliance with the Declaration of Helsinki 1964 and its later amendments.

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Informed consent was obtained from each participant of this study.

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Mondal, S., Dutta, S., Lahiri, D. et al. Assessment of nail unit structures by ultrasound in patients with psoriatic arthritis and their correlations with disease activity indices: a case–control study. Rheumatol Int 38, 2087–2093 (2018). https://doi.org/10.1007/s00296-018-4160-8

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  • DOI: https://doi.org/10.1007/s00296-018-4160-8

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