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Fingernail changes may predict more serious forms of systemic sclerosis

19 Jun 2017

Fingernail changes are predictors of more severe forms of systemic sclerosis (SSc) characterized by digital microangiopathy, including digital ulcers and calcinosis cutis, according to a recent study.

Researchers conducted a case-control study involving 129 patients with SSc and 80 healthy control participants who underwent routine fingernail examination to determine the prevalence of fingernail changes in SSc and to evaluate the association between fingernail changes and other features of SSc.

Fingernail changes in SSs had a prevalence of 80.6 percent. Compared with healthy control participants, patients with SSc were more likely to have trachyonychia (p=0.006), scleronychia (p<0.0001), thickened nails (p<0.0001), brachyonychia (p=0.0004), parrot beaking (p<0.0001), pterygium inversum unguis (p<0.0001), splinter haemorrhages (p<0.0001) and cuticle abnormalities (p<0.0001).

The presence of fingernail changes showed an association with digital ulcers (p<0.0001), calcinosis cutis (p=0.004) and higher values of mean nailfold videocappillaroscopy score (p=0.0009).

“Nail changes should be systematically checked in all patients with SSc, and may be included in the American College of Rheumatology/European League Against Rheumatism classification criteria for SSc,” according to researchers.

The study was limited by its cohort that originated from a single centre.

In connective tissue diseases (CTDs), the most important site of affection is the promixal nailfold. Specifically, splinter haemorrhages (p<0.05) and capillary loops in proximal nailfold (p<0.01) in fingernails were common in patients with SSc. Fingernail changes can thus be used in combination with highly sensitive diagnostic modalities to establish an accurate diagnosis, according to a previous study that assessed the frequency and the specificity of fingernail changes associated with CTDs. [J Eur Acad Dermatol Venereol 2007;21:497-503]

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Most Read Articles
Elvira Manzano, 4 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
14 Oct 2017
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