Association between enthesopathy and nail dystrophy of the extensor apparatus of the distal interphalangeal, assessed by ultrasonography in patients with psoriasis activity

• Grant number: 12/21170-9
• Support Opportunities: Regular Research Grants
• Start date: October 01, 2013
• End date: September 30, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Marcelo de Medeiros Pinheiro
• Grantee: Marcelo de Medeiros Pinheiro
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: Adriana Maria Porro ; Barbara Nascimento de Carvalho Klemz ; Karine Rodrigues da Luz

Abstract

The joint involvement is observed in approximately 30% of patients with psoriasis. However, no strategy clinic, laboratory or radiographic now is powerful enough to identify patients with psoriasis, asymptomatic from the standpoint of joint, which can evolve to AP in the short, medium or long term. Objectives: To study the association between psoriasis nail involvement and enthesopathy of the extensor apparatus of the distal interphalangeal, measured by ultrasound, and association with joint involvement (dactylitis, enthesitis, arthritis and axial) in patients with psoriasis activity.Patients and Methods: 140 patients will be included in both sexes and 18 years old, diagnosed with clinical activity in psoriasis vulgaris, through cross-sectional study with a control group. Patients with prior diagnosis of any rheumatic disease are excluded, or paronychia, whitlow, nail enamel and onychophagy. The dermatologist will apply the instruments PASI, NAPSI, PASE, Topas, PEST. The rheumatologist will assess the presence of dactylitis, enthesitis, axial arthritis or frames, and apply the criteria CASPAR, WINGS for inflammatory back pain, ASAS 2009 and the instruments and asdas DAS28 (CRP and ESR). Patients held ultrasound radiography and sacroiliac joints, entheses, skin and nails, according to the proposed parameters by OMERACT 2010. The evaluation will be blind. The performance of the new methodology will be evaluated using the area under the ROC curve (Receiver Operating Curve) and p values <0.05 are considered statistically significant. (AU)