{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:33:19Z","timestamp":1785861199146,"version":"3.56.0"},"reference-count":25,"publisher":"Scientific Scholar","content-domain":{"domain":["ijdvl.com"],"crossmark-restriction":true},"short-container-title":["IJDVL"],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Nail involvement in psoriasis is common and may be an indicator not only of disease severity, but also of the presence of psoriatic arthritis. However, the relationship of nail psoriasis with enthesitis remains under-explored.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Aims<\/jats:title>\n<jats:p>This study was conducted to evaluate the clinical, onychoscopic (nail dermatoscopic) and ultrasonographic features in patients with nail psoriasis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Materials and Methods<\/jats:title>\n<jats:p>All nails of twenty adult patients with nail psoriasis were examined clinically and onychoscopically. Patients were evaluated for psoriatic arthritis (Classification Criteria for Psoriatic Arthritis), the severity of cutaneous disease (Psoriasis Area Severity Index) and nail disease (Nail Psoriasis Severity Index). Ultrasonography of the clinically involved digits was performed for evidence of distal interphalangeal joint enthesitis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Results<\/jats:title>\n<jats:p>Out of 20 patients, 18 patients had cutaneous psoriasis and 2 had isolated nail involvement. Among the 18 patients with skin psoriasis, 4 had associated psoriatic arthritis. The most commonly observed clinical and onychoscopic features were pitting (31.2% and 42.2%), onycholysis (36% and 36.5%) and subungual hyperkeratosis (30.2% and 30.5%), respectively. Ultrasonographic evidence of distal interphalangeal joint enthesitis was seen in 57% (175\/307) of the digits with clinical nail involvement. Enthesitis was more common in patients with psoriatic arthritis (77% vs 50.6%). Nail thickening, crumbling and onychorrhexis (all features of nail matrix involvement) were significantly associated with enthesitis (<jats:italic>P<\/jats:italic> &lt; 0.005).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st5\">\n<jats:title>Limitation<\/jats:title>\n<jats:p>The major limitation was the small sample size and lack of controls. Only the clinically involved digits were evaluated for enthesitis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st6\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Enthesitis was frequently detected on ultrasonography in patients with nail psoriasis, even in clinically asymptomatic individuals. Nail features of thickening, crumbling and onychorrhexis may predict underlying enthesitis and the potential development of arthritis. A comprehensive evaluation could help identify patients with psoriasis at risk for arthritis, helping improve long-term outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijdvl_894_2022","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T09:41:54Z","timestamp":1683538914000},"page":"854-861","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Enthesopathy in patients with nail psoriasis \u2013 a cross-sectional evaluation of clinical, onychoscopic and ultrasonographic features"],"prefix":"10.25259","volume":"89","author":[{"given":"Anil Kumar","family":"Bhoi","sequence":"first","affiliation":[{"name":"Department of Dermatology and STD, University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chander","family":"Grover","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Singal","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupama","family":"Tandon","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,5,3]]},"reference":[{"key":"10.25259\/IJDVL_894_2022\/ref-1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.4103\/0019-5154.135470","article-title":"Nail psoriasis: The journey so far","volume":"59","author":"Dogra","year":"2014","journal-title":"Indian J Dermatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jaad.2005.07.073","article-title":"Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy","volume":"57","author":"Jiaravuthisan","year":"2007","journal-title":"J Am Acad Dermatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-3","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1159\/000246274","article-title":"Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients","volume":"193","author":"de Jong","year":"1996","journal-title":"Dermatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-4","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1159\/000512688","article-title":"The impact of nail psoriasis and treatment on quality of life: A systematic review","volume":"7","author":"Stewart","year":"2021","journal-title":"Skin Appendage Disord"},{"key":"10.25259\/IJDVL_894_2022\/ref-5","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1007\/s40257-021-00622-7","article-title":"Nail psoriasis and quality-of-life measurement in clinical trials: Call for the use of nail-specific instruments","volume":"22","author":"Blome","year":"2021","journal-title":"Am J Clin Dermatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-6","first-page":"2485","article-title":"Musculoskeletal ultrasound including definitions for ultrasonographic pathology","volume":"32","author":"Wakefield","year":"2005","journal-title":"J Rheumatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-7","doi-asserted-by":"publisher","first-page":"15","DOI":"10.4103\/0378-6323.125472","article-title":"Prevalence and clinical patterns of psoriatic arthritis in Indian patients with psoriasis","volume":"80","author":"Kumar","year":"2014","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"10.25259\/IJDVL_894_2022\/ref-8","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1111\/jdv.12368","article-title":"Nail psoriasis, the unknown burden of disease","volume":"28","author":"Klaassen","year":"2014","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.25259\/IJDVL_894_2022\/ref-9","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.jaad.2013.02.009","article-title":"Fingernail psoriasis reconsidered: A case-control study","volume":"69","author":"van der Velden","year":"2013","journal-title":"J Am Acad Dermatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-10","doi-asserted-by":"publisher","first-page":"650","DOI":"10.4103\/ijdvl.IJDVL_795_16","article-title":"Clinical and serological characteristics of nail psoriasis in Indian patients: A cross-sectional study","volume":"83","author":"Daulatabad","year":"2017","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"10.25259\/IJDVL_894_2022\/ref-11","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1159\/000508165","article-title":"Dermoscopic features of nail psoriasis: An observational, analytical study","volume":"6","author":"Chauhan","year":"2020","journal-title":"Skin Appendage Disord"},{"key":"10.25259\/IJDVL_894_2022\/ref-12","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s10067-010-1623-z","article-title":"The role of ultrasound in rheumatic skin and nail lesions: A multi-specialist approach","volume":"30","author":"Wortsman","year":"2011","journal-title":"Clin Rheumatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.semarthrit.2017.12.008","article-title":"Enthesitis: a hallmark of psoriatic arthritis","volume":"48","author":"Kaeley","year":"2018","journal-title":"Semin Arthritis Rheum"},{"key":"10.25259\/IJDVL_894_2022\/ref-14","doi-asserted-by":"publisher","first-page":"8251097","DOI":"10.1155\/2018\/8251097","article-title":"Ultrasound assessment of changes in nails in psoriasis and psoriatic arthritis","volume":"2018","author":"Krajewska-W\u0142odarczyk","year":"2018","journal-title":"Biomed Res Int"},{"key":"10.25259\/IJDVL_894_2022\/ref-15","doi-asserted-by":"publisher","first-page":"3628","DOI":"10.1038\/s41598-019-39985-7","article-title":"Distal interphalangeal joint extensor tendon enthesopathy in patients with nail psoriasis","volume":"9","author":"Krajewska-W\u0142odarczyk","year":"2019","journal-title":"Sci Rep"},{"key":"10.25259\/IJDVL_894_2022\/ref-16","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.1093\/rheumatology\/ker078","article-title":"High prevalence of ultrasonographic synovitis and enthesopathy in patients with psoriasis without psoriatic arthritis: A prospective case-control study","volume":"50","author":"Naredo","year":"2011","journal-title":"Rheumatology (Oxford)"},{"key":"10.25259\/IJDVL_894_2022\/ref-17","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1159\/000343607","article-title":"Ultrasonographic assessment of nail in psoriatic disease shows a link between onychopathy and distal interphalangeal joint extensor tendon enthesopathy","volume":"225","author":"Aydin","year":"2012","journal-title":"Dermatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-18","doi-asserted-by":"publisher","first-page":"1102","DOI":"10.1111\/ddg.12989","article-title":"Nail involvement can predict enthesopathy in patients with psoriasis","volume":"14","author":"Castellanos-Gonz\u00e1lez","year":"2016","journal-title":"J Dtsch Dermatol Ges"},{"key":"10.25259\/IJDVL_894_2022\/ref-19","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1007\/s10067-016-3319-5","article-title":"Psoriatic nail involvement and its relationship with distal interphalangeal joint disease","volume":"35","author":"Lai","year":"2016","journal-title":"Clin Rheumatol"},{"key":"10.25259\/IJDVL_894_2022\/ref-20","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.semarthrit.2010.05.009","article-title":"Subclinical entheseal involvement in patients with psoriasis: an ultrasound study","volume":"40","author":"Gutierrez","year":"2011","journal-title":"Semin Arthritis Rheum"},{"key":"10.25259\/IJDVL_894_2022\/ref-21","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1002\/art.21736","article-title":"A high-resolution magnetic resonance imaging study of distal interphalangeal joint arthropathy in psoriatic arthritis and osteoarthritis: are they the same?","volume":"54","author":"Tan","year":"2006","journal-title":"Arthritis Rheum"},{"key":"10.25259\/IJDVL_894_2022\/ref-22","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1093\/rheumatology\/kel214","article-title":"The relationship between the extensor tendon enthesis and the nail in distal interphalangeal joint disease in psoriatic arthritis\u2014a high-resolution MRI and histological study","volume":"46","author":"Tan","year":"2007","journal-title":"Rheumatology (Oxford)"},{"key":"10.25259\/IJDVL_894_2022\/ref-23","doi-asserted-by":"publisher","first-page":"2665","DOI":"10.1002\/art.21972","article-title":"Classification criteria for psoriatic arthritis: Development of new criteria from a large international study","volume":"54","author":"Taylor","year":"2006","journal-title":"Arthritis Rheum"},{"key":"10.25259\/IJDVL_894_2022\/ref-24","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1136\/annrheumdis-2011-200478","article-title":"Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails","volume":"71","author":"Ash","year":"2012","journal-title":"Ann Rheum Dis"},{"key":"10.25259\/IJDVL_894_2022\/ref-25","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1080\/1744666X.2016.1193436","article-title":"Improvements in diagnostic tools for early detection of psoriatic arthritis","volume":"12","author":"D\u2019Angelo","year":"2016","journal-title":"Expert Rev Clin Immunol"}],"container-title":["Indian Journal of Dermatology, Venereology and Leprology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ijdvl.com\/enthesopathy-in-patients-with-nail-psoriasis-a-cross-sectional-evaluation-of-clinical-onychoscopic-and-ultrasonographic-features\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ijdvl.com\/enthesopathy-in-patients-with-nail-psoriasis-a-cross-sectional-evaluation-of-clinical-onychoscopic-and-ultrasonographic-features\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T05:48:24Z","timestamp":1698472104000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ijdvl.com\/enthesopathy-in-patients-with-nail-psoriasis-a-cross-sectional-evaluation-of-clinical-onychoscopic-and-ultrasonographic-features\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,3]]},"references-count":25,"alternative-id":["10.25259\/IJDVL_894_2022"],"URL":"https:\/\/doi.org\/10.25259\/ijdvl_894_2022","relation":{},"ISSN":["0973-3922","0378-6323"],"issn-type":[{"value":"0973-3922","type":"electronic"},{"value":"0378-6323","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,3]]},"article-number":"854"}}