RHIO (Rheumatology, Immunology, Osteology) Düsseldorf and RHIO Research Institute, Düsseldorf, Germany.
Department of Medicine III, Rheumatology, Helios St. Johannes Medical Center, Duisburg, Germany.
J Dtsch Dermatol Ges. 2019 Feb;17(2):138-147. doi: 10.1111/ddg.13747. Epub 2019 Jan 31.
Early diagnosis of psoriatic arthritis poses a particular challenge. A novel fluorescence optical imaging technique, the Xiralite® system is very useful in this regard as it allows for visualization of microvasculature and perfusion. The present study is the first to systematically examine fluorescence optical signals in a large psoriatic arthritis cohort.
In the primary study, we reviewed and analyzed extra-articular fluorescence optical signal patterns in 241 imaging sequences obtained from 187 psoriatic arthritis patients; 36 fluorescence optical sequences from 31 patients with rheumatoid arthritis served as controls. In a follow-up study, 203 consecutive fluorescence optical sequences from 54 psoriatic arthritis patients and 149 control subjects with various inflammatory rheumatic disorders were retrospectively evaluated in order to validate the primary study results in terms of the patterns previously identified.
Psoriatic arthritis patients exhibited three different fluorescence optical signal patterns in projection of the nails that have not been previously described. One of these patterns was the "green nail" sign, which was highly specific (97 %) for psoriatic arthritis. In the follow-up study, the specificity of this phenomenon in psoriatic arthritis was 87 % in comparison to the control cohort.
In the present study, fluorescence optical signals in the nail region proved to be highly specific for psoriatic arthritis. The "green nail" phenomenon seems to be of particular diagnostic interest as a potential sign of impaired microcirculation of the nail bed.
早期诊断银屑病关节炎具有一定挑战性。一种新型荧光光学成像技术——Xiralite®系统在这方面非常有用，因为它可以可视化微血管和灌注。本研究首次系统地检查了大型银屑病关节炎队列中的荧光光学信号。
在初步研究中，我们回顾和分析了 187 例银屑病关节炎患者的 241 个影像学序列的关节外荧光光学信号模式；31 例类风湿关节炎患者的 36 个荧光光学序列作为对照。在后续研究中，回顾性评估了 54 例银屑病关节炎患者的 203 个连续荧光光学序列和 149 例患有各种炎症性风湿性疾病的对照受试者，以验证初步研究结果中先前确定的模式。
银屑病关节炎患者在指甲投影中表现出三种以前未描述的不同荧光光学信号模式。其中一种模式是“绿指甲”征，对银屑病关节炎具有高度特异性（97%）。在后续研究中，与对照组相比，这种现象在银屑病关节炎中的特异性为 87%。
本研究表明，指甲区域的荧光光学信号对银屑病关节炎具有高度特异性。“绿指甲”现象似乎具有特别的诊断意义，可能是甲床微循环受损的潜在迹象。
