P.J. Mease, MD, Swedish Medical Center/Providence St. Joseph Health and University of Washington, Seattle, Washington;
M. Liu, PhD, S. Rebello, MPH, R.R. McLean, DSc, MPH, B. Dube, MPH, M. Glynn, MS, CPH, Corrona, LLC, Waltham, Massachusetts.
J Rheumatol. 2021 Apr;48(4):520-526. doi: 10.3899/jrheum.190923. Epub 2020 Oct 15.
To examine the association of nail psoriasis with disease activity, quality of life, and work productivity in patients with psoriatic arthritis (PsA).
All patients with PsA who enrolled in the Corrona PsA/Spondyloarthritis Registry between March 2013 and October 2018 and had data on physician-reported nail psoriasis were included and stratified by presence vs absence of nail psoriasis at enrollment. Patient demographics, disease activity, quality of life (QOL), and work productivity at enrollment were compared between patients with vs without nail psoriasis using -tests or Wilcoxon rank-sum tests for continuous variables and chi-square or Fisher exact tests for categorical variables.
Of the 2841 patients with PsA included, 1152 (40.5%) had nail psoriasis and 1689 (59.5%) did not. Higher proportions of patients with nail psoriasis were male (51.9% vs 44.1%) and disabled from working (12.3% vs 7.8%) compared with patients without nail psoriasis (all < 0.05). Patients with nail psoriasis had higher disease activity than those without nail psoriasis, including higher tender and swollen joint counts, worse Disease Activity Index for Psoriatic Arthritis and Psoriatic Arthritis Disease Activity Score values, and increased likelihood of having enthesitis and dactylitis (all < 0.05). Patients with nail psoriasis had worse pain, fatigue, and work and activity impairment than those without nail psoriasis (all < 0.05).
Patients with PsA who have nail psoriasis had worse disease activity, QOL, and work productivity than those without nail involvement, emphasizing the importance of identification and management of nail disease in patients with PsA.
探讨银屑病关节炎（PsA）患者指甲银屑病与疾病活动度、生活质量和工作生产力的关系。
纳入 2013 年 3 月至 2018 年 10 月期间在 Corrona PsA/Spondyloarthritis 注册中心登记的所有存在医生报告的指甲银屑病的 PsA 患者，并根据登记时是否存在指甲银屑病进行分层。使用 -检验或 Wilcoxon 秩和检验比较指甲银屑病患者与无指甲银屑病患者之间的患者人口统计学特征、疾病活动度、生活质量（QOL）和工作生产力，对于分类变量则使用卡方检验或 Fisher 确切检验。
在纳入的 2841 例 PsA 患者中，1152 例（40.5%）患有指甲银屑病，1689 例（59.5%）无指甲银屑病。指甲银屑病患者中，男性（51.9%比 44.1%）和丧失工作能力的患者（12.3%比 7.8%）比例高于无指甲银屑病患者（均<0.05）。指甲银屑病患者的疾病活动度高于无指甲银屑病患者，包括更高的压痛关节数和肿胀关节数、更差的银屑病关节炎疾病活动指数和银屑病关节炎疾病活动评分，以及增加发生附着点炎和指炎的可能性（均<0.05）。指甲银屑病患者的疼痛、疲劳以及工作和活动能力障碍程度比无指甲银屑病患者更严重（均<0.05）。
患有指甲银屑病的 PsA 患者的疾病活动度、生活质量和工作生产力均较无指甲受累者差，这强调了识别和管理银屑病关节炎患者指甲疾病的重要性。
