{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:51:29Z","timestamp":1791039089334,"version":"4.1.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>This pilot study investigates distinctive features within the nail-enthesis complex among Psoriatic arthritis (PsA), Psoriasis (PSO), Rheumatoid Arthrit is (RA), and Healthy Control (HC) groups, utilizing a combined approach of ultrasound (US) and nailfold videocapillaroscopy (NVC). Clinical assessments and comprehensive US and NVC evaluations of the nail-enthesis complex were conducted on 72 subjects (18 PsA, 16 PSO, 19 RA, 19 HC). Unsupervised clustering models and factor analysis were employed to identify patterns and interrelationships between US and NVC parameters. Significant structural differences were detected, emphasizing the discriminatory power of semiquantitative US scores (GS BUNES, Wortsman type). Trends in vascularization aligned with literature, showcasing dysregulated angiogenesis in PsA and PSO. The clustering model effectively distinguished HC from PsA subjects, revealing a potential continuum between PSO and PsA. RA subjects exhibited subsets with features akin to both HC and PsA\/PSO, underscoring the complexity of its manifestations. This study provides insights into nail-enthesis complex alterations, highlighting distinctions among PsA, PSO, RA, and HC subjects. The clustering model emphasizes potential overlap between PSO and PsA. Factor analysis elucidates collinearity in US-detected characteristics, while suggesting limited discriminative power of some quantitative parameters. These findings advocate for further exploration in prospective trials, potentially predicting the evolution of undifferentiated early arthritis and arthritis onset in PSO patients.<\/jats:p>","DOI":"10.3389\/fimmu.2024.1505322","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:11:13Z","timestamp":1736813473000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Combined semiquantitative nail-enthesis complex ultrasonography and capillaroscopy in psoriasis and psoriatic arthritis"],"prefix":"10.3389","volume":"15","author":[{"given":"Giacomo","family":"Cafaro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Bursi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Valentini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Hansel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Perricone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Venerito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onelia","family":"Bistoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Sebastiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Topini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Stingeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Gerli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bartoloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-018-4012-7","article-title":"Psoriatic arthritis: tissue-directed inflammation","volume":"37","author":"Cafaro","year":"2018","journal-title":"Clin Rheumatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1038\/s41572-021-00293-y","article-title":"Psoriatic arthritis","volume":"7","author":"FitzGerald","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000000054","article-title":"Ultrasound nail imaging on patients with psoriasis and psoriatic arthritis compared with rheumatoid arthritis and control subjects","volume":"20","author":"Sandobal","year":"2014","journal-title":"J Clin Rheumatol"},{"key":"B4","doi-asserted-by":"publisher","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\u2013a high-resolution MRI and histological study","volume":"46","author":"Tan","year":"2007","journal-title":"Rheumatol (Oxford)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-019-04437-0","article-title":"The ultrasonographic study of the nail reveals differences in patients affected by inflammatory and degenerative conditions","volume":"38","author":"Idolazzi","year":"2019","journal-title":"Clin Rheumatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-005-0044-5","article-title":"Angiogenesis in psoriasis and psoriatic arthritis: clues to disease pathogenesis","volume":"7","author":"Leong","year":"2005","journal-title":"Curr Rheumatol Rep"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.mvr.2012.03.002","article-title":"Capillaroscopic pattern in inflammatory arthritis","volume":"83","author":"Lambova","year":"2012","journal-title":"Microvasc Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1285005","article-title":"Editorial: Update in microcirculation in dermatology","volume":"10","author":"Trevisan","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"B9","first-page":"53","article-title":"Psoriatic microangiopathy modifications induced by PUVA and etretinate therapy. A nail-fold capillary microscopic study","volume":"146","author":"Trevisan","year":"1989","journal-title":"Acta Derm Venereol Suppl (Stockh)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170146","article-title":"Nail enthesis ultrasound in psoriasis and psoriatic arthritis: A report from the 2016 GRAPPA annual meeting","volume":"44","author":"Cunha","year":"2017","journal-title":"J Rheumatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/rap\/rkab088","article-title":"The relationship between the nail and systemic enthesitis in psoriatic arthritis","volume":"5","author":"Elliott","year":"2021","journal-title":"Rheumatol Adv Pract"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2021-002109","article-title":"Multimodal imaging of the distal interphalangeal-joint synovio-entheseal complex in psoriatic arthritis (MIDAS): a cross-sectional study on the diagnostic accuracy of different imaging modalities comparing psoriatic arthritis to psoriasis and osteoarthritis","volume":"8","author":"Guldberg-M\u00f8ller","year":"2022","journal-title":"RMD Open"},{"key":"B13","doi-asserted-by":"publisher","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":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology\/Europve initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2006.03.014","article-title":"Ultrasound imaging of nails","volume":"24","author":"Wortsman","year":"2006","journal-title":"Dermatol Clin"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213609","article-title":"Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative","volume":"77","author":"Balint","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev441","article-title":"An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases","volume":"55","author":"Smith","year":"2016","journal-title":"Rheumatol (Oxford)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"B19","unstructured":"Unsupervised deep embedding for clustering analysis\n          \n          \n            \n              Xie\n              J\n            \n            \n              Girshick\n              R\n            \n            \n              Farhadi\n              A\n            \n          \n          PMLR\n          Proceedings of The 33rd International Conference on Machine Learning\n          \n          2016"},{"key":"B20","article-title":"Visualizing Data using t-SNE","volume":"9","author":"van der Maaten","year":"2008","journal-title":"J Mach Learn Res"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1037\/h0036316","article-title":"When is a correlation matrix appropriate for factor analysis? Some decision rules","volume":"81","author":"Dziuban","year":"1974","journal-title":"psychol Bull"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-012-1274-9","article-title":"Ultrasonography reveals nail thickening in patients with chronic plaque psoriasis","volume":"304","author":"Gisondi","year":"2012","journal-title":"Arch Dermatol Res"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.11152\/mu-1327","article-title":"Ultrasonography of the nail unit reveals quantitative and qualitative alterations in patients with psoriasis and psoriatic arthritis","volume":"20","author":"Idolazzi","year":"2018","journal-title":"Med Ultrason"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.11152\/mu.2013.2066.183.hgh","article-title":"High-frequency sonography in the evaluation of nail psoriasis","volume":"18","author":"Marina","year":"2016","journal-title":"Med Ultrason"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-018-4160-8","article-title":"Assessment of nail unit structures by ultrasound in patients with psoriatic arthritis and their correlations with disease activity indices: a case-control study","volume":"38","author":"Mondal","year":"2018","journal-title":"Rheumatol Int"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-019-04748-2","article-title":"Nail ultrasonography for psoriatic arthritis and psoriasis patients: a systematic literature review","volume":"39","author":"Fassio","year":"2020","journal-title":"Clin Rheumatol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s42358-019-0081-9","article-title":"The use of ultrasonography in the diagnosis of nail disease among patients with psoriasis and psoriatic arthritis: a systematic review","volume":"59","author":"Mendon\u00e7a","year":"2019","journal-title":"Adv Rheumatol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2016.10.005","article-title":"Detection of subclinical ultrasound enthesopathy and nail disease in patients at risk of psoriatic arthritis","volume":"84","author":"Acquitter","year":"2016","journal-title":"Joint Bone Spine"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.05.002","article-title":"Ultrasound entheseal abnormalities at the distal interphalangeal joints and clinical nail involvement in patients with psoriasis and psoriatic arthritis, supporting the nail-enthesitis theory","volume":"47","author":"Acosta-Felquer","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"B30","doi-asserted-by":"publisher","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":"Dermatology"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15035","article-title":"Subclinical enthesopathy of extensor digitorum tendon is highly prevalent and associated with clinical and ultrasound alterations of the adjacent fingernails in patients with psoriatic disease","volume":"32","author":"Moya Alvarado","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.mvr.2023.104476","article-title":"Nailfold capillaroscopy as diagnostic test in patients with psoriasis and psoriatic arthritis: A systematic review","volume":"147","author":"Lazar","year":"2023","journal-title":"Microvasc Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2000.03544.x","article-title":"Nailfold video capillaroscopy in psoriasis","volume":"142","author":"Bhushan","year":"2000","journal-title":"Br J Dermatol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.13438","article-title":"Dermoscopy of nail fold and elbow in the differential diagnosis of early psoriatic arthritis sine psoriasis and early rheumatoid arthritis","volume":"43","author":"Errichetti","year":"2016","journal-title":"J Dermatol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170962","article-title":"Early psoriatic arthritis versus early seronegative rheumatoid arthritis: role of dermoscopy combined with ultrasonography for differential diagnosis","volume":"45","author":"Zabotti","year":"2018","journal-title":"J Rheumatol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac664","article-title":"Utility of nailfold capillary assessment for predicting psoriatic arthritis based on a prospective observational cohort study","volume":"62","author":"Fukasawa","year":"2023","journal-title":"Rheumatol (Oxford)"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1505322\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:11:18Z","timestamp":1736813478000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1505322\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,14]]},"references-count":36,"alternative-id":["10.3389\/fimmu.2024.1505322"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2024.1505322","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,14]]},"article-number":"1505322"}}