Clinical and Dermoscopic Comparison of Rheumatoid Arthritis, Ankylosing Spondylitis and Psoriasis Patients' Nails

Completed

• Conditions: Spondylarthropathies; Psoriatic Nail; Psoriasis Circinata; Rheumatoid Arthritis; Psoriatic Arthritis
• Interventions: Diagnostic Test: Dermoscopic examination

• Registration Number: NCT04709354
• Lead Sponsor: Bezmialem Vakif University

Brief Summary

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.

Detailed Description

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.

Study Timeline

• Study Start: 2021-01-01
• Study First Submitted: 2021-01-11
• Study First Submitted QC: 2021-01-13
• Study First Posted: 2021-01-14
• Primary Completion: 2021-11-20
• Status Verified: 2021-12
• Study Completion: 2021-12-20
• Last Update Submitted: 2021-12-20
• Last Update Posted: 2021-12-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

• Psoriasis confirmed by dermatologist.
• Rheumatoid arthritis, ankylosing spondylitis confirmed by rheumatologist (newly diagnosed).

Exclusion Criteria

• Unable to consent and understand
• Patients with confirmed onychomycosis
• Patients receiving biological therapy

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
psoriatic arthritis	Dermoscopic examination	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.
rheumatoid arthritis patient	Dermoscopic examination	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	Dermoscopic examination	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.
psoriasis patients without joint involvement	Dermoscopic examination	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.

Primary Outcome Measures

Name	Time	Method
Comparation of clinical features of nails	six months	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
NAPSI (Psoriasis Area and Severity index)	six months	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.
Comparation of dermoscopic features of nails	six months	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.
PASI (Psoriasis Area and Severity Index)	six months	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.

Secondary Outcome Measures

Name	Time	Method
Demographic characteristics	through study completion, an average of 6 months	Demographic characteristics of patients will be compared.

Trial Locations

Locations (1)

Bezmialem Vakıf Univesity; 🇹🇷 Istanbul, Turkey