scholarly journals Treatments for Nail Psoriasis: A Systematic Review by the GRAPPA Nail Psoriasis Work Group

2014 ◽  
Vol 41 (11) ◽  
pp. 2306-2314 ◽  
Author(s):  
April W. Armstrong ◽  
William Tuong ◽  
Thorvardur J. Love ◽  
Sueli Carneiro ◽  
Rachel Grynszpan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Health Outcomes ◽  
Work Group ◽  
Treatment Recommendations ◽  
Systematic Analysis ◽  
Nail Psoriasis ◽  
Nail Involvement

Nail involvement in psoriatic diseases causes significant physical and functional disabilities. Evaluating, measuring, and treating nail involvement is important in improving the health outcomes and quality of life among patients with psoriasis and psoriatic arthritis (PsA). We performed a systematic analysis of the literature on nail psoriasis to help inform an update of treatment recommendations by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

scholarly journals POS1072 ASSOCIATION OF NAIL PSORIASIS WITH WORSE DISEASE OUTCOMES IN PSORIATIC ARTHRITIS PATIENTS. DATA FROM CLINICAL PRACTICE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 815.2-815
Author(s):  
E. Gubar ◽  
Y. Korsakova ◽  
E. Loginova ◽  
S. Glukhova ◽  
T. Korotaeva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Severe Disease ◽  
Work Productivity ◽  
Disease Status ◽  
Nail Psoriasis ◽  
Nail Involvement

Background:Limited data are available regarding the burden of nail disease in psoriatic arthritis (PsA). The latest data show that nail involvement in PsA patients (pts) is associated with significantly more severe disease status (1).Objectives:To analyze, in clinical practice, the association of nail psoriasis with disease activity, quality of life, and work productivity in PsA pts.Methods:588 pts (M/F–277 /311) with PsA according to CASPAR criteria were included in the study. Data were collected from 43 rheumatology clinics from different regions of the Russian Federation. Pts’ age 48.6±0.5 years (yrs), disease duration 7.0±0.3 yrs. Pts underwent standard clinical examination of PsA activity. Pts were split into two groups (gr.): those with nail psoriasis – gr.1, and those without it – gr.2. Demographics, disease activity, quality of life, and work productivity were compared between pts with and without nail psoriasis using Pearson’s chi-square test and Mann–Whitney U test.Results:Gr.1 includes 312 (53.1%) cases, gr.2 – 276 (46.9%) cases. More pts in gr.1 were males (51.9% vs 44.1%, р=0.013), disabled at work (37.20% vs 26.40%, р=0.000), chronic smokers (18.9% vs 8.7%, р=0.000) and with axial PsA disease signs according to physician (35.0% vs 26.4%, р=0.025) compared to pts in gr.2. Pts in gr.1 had higher tender and swollen joint counts: 8 [4-15] vs 5 [2-12] (р=0.002) and 5 [1-9] vs 2 [0-7] (р=0.003) respectively. Gr.1 pts had higher disease activity measured by DAPSA 25 [15-39] vs 20 [12-33] (p= 0.001), higher frequency of dactylitis (24.4% vs 16.7% р=0.022) and heel enthesitis (17.0% vs 10.1% р=0.016) respectively, higher frequency of erosive radiographic arthritis of feet (45.0% vs 31.2% р=0.003) compared to gr.2 pts. Pts in gr.1 had worse skin psoriasis measured by Psoriasis Area Severity Index – 6 [2-14] vs 3 [1-6] (р=0.000). Less pts in gr.1 than in gr.2 (27.0% vs 52.0% р=0.004) achieved minimal disease activity (MDA). Pts’ reported outcomes (PRO’s) in gr.1 were worse than in gr.2 in regard to reduced health-related quality of life according to PsAID (4.9±2.3 vs 4.0±2.3, р=0.040) and to EQ-5D (0.56±0.19 vs 0.64 ±0.21, р=0.024) questionnaires, overall work impairment (0.0 [0.0-0.3] vs 0.0 [0.0-0.2], р=0.034) and overall activity impairment (0.4 [0.1-0.7] vs 0.3 [0.0-0.5], р=0.006) according to WPAI.Conclusion:Nail involvement in PsA pts is associated with male gender and axial disease. PsA pts with nail involvement are more often disabled, more often are chronic smokers, have significantly worse disease status as measured by disease activity; they are more likely to have more severe (erosive) peripheral arthritis of feet, higher frequency of heel enthesitis and dactylitis, higher psoriasis disease severity, lower frequency of MDA achievement, and worse quality of life and work productivity according to PRO’s. Detection of nail involvement is critical for choice of treatment approach and better outcomes.References:[1]Mease PJ et al.J Rheumatol, 2020Disclosure of Interests:None declared.

Psoriatic Nail Disease: Quality of Life and Treatment

2009 ◽  
Vol 13 (5_suppl) ◽  
pp. S102-S106 ◽  
Author(s):  
Aditya K. Gupta ◽  
Elizabeth A. Cooper
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
Plaque Psoriasis ◽  
Large Scale ◽  
Severity Index ◽  
Biologic Therapies ◽  
Nail Psoriasis ◽  
Psoriatic Nail Disease

Nail psoriasis is common among patients with plaque psoriasis or psoriatic arthritis and has a detrimental effect on quality of life. However, there are currently no standardized therapeutic regimens for nail psoriasis. Traditional treatments for nail psoriasis, which include topical, intralesional, and oral therapies, may be time-consuming, painful, or unsafe when administered long term. Biologic therapies have demonstrated efficacy for plaque psoriasis and psoriatic arthritis; these therapies may be particularly promising for the treatment of nail psoriasis as both groups of patients have an elevated incidence of nail dystrophy. The biologic therapies adalimumab, alefacept, efalizumab, etanercept, and infliximab have demonstrated clinically important nail psoriasis improvements using the Nail Psoriasis Severity Index, a helpful tool that, upon validation, will allow comparison across treatments and trials. Large-scale, long-term trials using standardized outcome measures are needed to further evaluate biologic therapies for the treatment of nail psoriasis.

scholarly journals Treatment with intralesional methotrexate injection in a patient with nail psoriasis

2022 ◽  
Vol 13 (1) ◽  
pp. 62-64
Author(s):  
Yesim Akpinar Kara
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Topical Treatment ◽  
Psoriasis Vulgaris ◽  
Corticosteroid Injection ◽  
Inflammatory Skin Disease ◽  
Nail Psoriasis ◽  
Nail Involvement ◽  
Systemic Therapies

Psoriasis vulgaris is an inflammatory skin disease involving the skin, nails, and joints. While nail involvement is observed in 70–80% of patients with psoriasis, the rate of patients with isolated nail involvement is 5–10%. Dystrophies arising in the nails in psoriasis affect the patient’s quality of life, and local and systemic therapies may be used as treatment. Intralesional methotrexate or corticosteroid injection might be an option in the treatment of patients with the involvement of one nail or some nails or without the involvement of the skin and joints, due to the side effects of systemic and biological agents. Herein, we report a female patient with nail psoriasis resistant to a previously applied topical treatment, the efficacy of intralesional methotrexate without the use of a systemic antipsoriatic agent, and no progression of side effects.

Health outcomes attributable to carbapenemase-producing Enterobacteriaceae infections: A systematic review and meta-analysis

2019 ◽  
Vol 41 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Dalton R. Budhram ◽  
Stephen Mac ◽  
Joanna M. Bielecki ◽  
Samir N. Patel ◽  
Beate Sander
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Hospital Mortality ◽  
Health Outcomes ◽  
Bloodstream Infection ◽  
Meta Analysis ◽  
Quality Appraisal ◽  
Reported Health

AbstractBackground:Carbapenemase-producing Enterobacteriaceae (CPE) pose a significant global health threat.Objective:To conduct a systematic review of health outcomes and long-term sequelae attributable to CPE infection.Methods:We followed PRISMA reporting guidelines and published our review protocol on PROSPERO (CRD42018097357). We searched Medline, Embase, CINAHL and the Cochrane Library. We included primary studies with a carbapenem-susceptible control group in high-income countries, published in English. Quality appraisal was completed using Joanna Briggs Institute checklists. We qualitatively summarized frequently reported outcomes and conducted a meta-analysis.Results:Our systematic review identified 8,671 studies; 17 met the eligibility criteria for inclusion. All studies reported health outcomes; none reported health-related quality-of-life. Most studies were from Europe (65%), were conducted in teaching or university-affiliated hospitals (76%), and used case-control designs (53%). Mortality was the most commonly reported consequence of CPE-infections; in-hospital mortality was most often reported (62%). Our meta-analysis (n = 5 studies) estimated an absolute risk difference (ARD) for in-hospital bloodstream infection mortality of 0.25 (95% confidence interval [CI], 0.17–0.32). Duration of antibiotic therapy (range, 4–29.7 vs 1–23.6 days) and length of hospital stay (range, 21–87 vs 15–43 days) were relatively higher for CPE-infected patients than for patients infected with carbapenem-susceptible pathogens. Most studies (82%) met >80% of their respective quality appraisal criteria.Conclusions:The risk of in-hospital mortality due to CPE bloodstream infection is considerably greater than carbapenem-susceptible bloodstream infection (ARD, 0.25; 95% CI, 0.17–0.32). Health outcome studies associated with CPE infection are focused on short-term (eg, in-hospital) outcomes; long-term sequelae and quality-of-life are not well studied.Trial Registration:PROSPERO (CRD42018097357).

scholarly journals Interventions to address health outcomes among autistic adults: A systematic review

Autism ◽  
2020 ◽  
Vol 24 (6) ◽  
pp. 1345-1359 ◽  
Author(s):  
Teal W Benevides ◽  
Stephen M Shore ◽  
May-Lynn Andresen ◽  
Reid Caplan ◽  
Barb Cook ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Systematic Review ◽  
Health Outcome ◽  
Health Outcomes ◽  
Intervention Studies ◽  
Expert Opinions ◽  
Primary Health ◽  
Autistic Adults

Research has shown that autistic adults have poor health outcomes. We conducted a systematic review to identify existing interventions to address health outcomes for autistic adults and to determine whether these interventions address the priorities of the autistic community. We searched PubMed for articles that included an intervention, a primary health outcome measured at the individual (not system) level, and a sample population of at least 50% autistic adults. Studies were excluded if they were not peer-reviewed, had a focus on caregivers, were expert opinions on specific interventions, untested protocols, or interventions without a primary health outcome. Out of the 778 articles reviewed, 19 were found to meet the stated criteria. Based on the evidence gathered, two were considered emerging evidence-based approaches: cognitive behavioral approaches and mindfulness. The remaining interventions included in the review did not have sufficient evidence to support current use with this population. The majority of the studies included samples of young autistic adults, primarily male, without an intellectual disability. Anxiety, quality of life, depression, and behavioral issues were among the health outcomes measured in the final included articles. More research on preferred interventions with prioritized health outcomes of the autistic adult population is needed. Lay abstract Autistic adults have more health problems then their same-aged peers. Yet little research has been conducted that focuses on addressing these health problems. In order to guide future research, it is important to know what intervention studies have been done to improve health outcomes among autistic adults. The project team and student assistants read studies that were published between 2007 and 2018 in the online research database, PubMed. We looked for studies published in English, which were peer-reviewed and included (1) an intervention, (2) an outcome that was related to health, and (3) a study group that included autistic adults. We did not include studies that had outcomes about employment (unless there was a health outcome), studies about caregivers or caregiving, or expert opinions about interventions. Of 778 reviewed articles, 19 studies met all of the criteria above. Within these studies, two approaches were found to have emerging evidence for their use in autistic adults: cognitive behavioral interventions and mindfulness-based approaches for improved mental health outcomes. The remaining intervention approaches did not have enough articles to support their use. Many of the outcomes were about reduced symptoms of co-occurring mental health diagnoses (e.g. reduced anxiety, depression). Most of the participants in these studies were male and did not have intellectual disability. Most study participants were adults younger than 40. There are not many intervention studies that address health outcomes among autistic adults. More research is needed on interventions which are desired by the adult autism community and address preferred health outcomes such as increased quality of life or well-being.

Clinico-Epidemiological Characteristics and Impact on Quality of Life in Psoriatic Patients with and without Nail Changes - A Nepalese Experience

2021 ◽  
Vol 8 (06) ◽  
pp. 306-312
Author(s):  
Shikha Khare ◽  
Sudha Agrawal
Keyword(s):  
Quality Of Life ◽  
Age Of Onset ◽  
Severity Index ◽  
Joint Involvement ◽  
Skin Involvement ◽  
Nail Psoriasis ◽  
Nail Changes ◽  
Epidemiological Characteristics ◽  
Nail Involvement

BACKGROUND Nail involvement in psoriasis is likely to influence the quality of life (QOL) because of its highly visible site; however, the impact of this disease on QOL is an underexplored area. Similarly, the relationship between severity of skin involvement and nail involvement has been overlooked. The study was conducted to evaluate the clinico-epidemiological characteristics of psoriasis patients with and without nail changes and assess the health-related quality of life (HRQOL). Furthermore, the correlation of severity of nail involvement with the severity of skin involvement and its impact on quality of life was assessed. METHODS A total of 370 adult psoriasis patients with or without nail changes was studied. Skin severity was assessed by body surface area (BSA) and Psoriasis Area and Severity Index (PASI) while nail severity was assessed using Nail Psoriasis Severity Index (NAPSI). Patients’ quality of life was measured using the Nepali Version of Dermatology Life Quality Index (DLQI). RESULTS Nail psoriasis was more prevalent in males in both the groups; females were having more nail involvement (0.041). There were no significant diff erences in other clinico-epidemiologic characteristics between these two groups except the late onset of psoriasis in the age group > 30 years, scalp involvement and absence of family history of psoriasis (P ≤ 0.05). There was a strong positive correlation between the age of onset of skin changes with age of onset of nail involvement (r = 0.799) and the joint involvement (r = 0.742) as well as the age of onset of joint involvement with nail changes (r = 0.838). The mean PASI was 7.265 ± 7.153 vs. 6.189 ± 7.153 in patients with > 10 vs. ≤ 10 total NAPSI score and it was statistically significant (P = 0.011), however, there was a moderate positive correlation between PASI and NAPSI (r = 0.32). Almost half of psoriasis patients had very large to extremely large effects on quality of life but leisure and treatment domain were affected more amongst patients with nail changes. Early onset of joint involvement, body surface area of > 3 % involvement and PASI score > 5 had significant effect on quality of life. CONCLUSIONS The nail involvement is an important finding in determining the severity of skin involvement and had very large to extremely large effect on quality of life particular on leisure and treatment domain. Therefore, nail examination must be done in all psoriatic patients. KEYWORDS Nail Psoriasis, Quality of Life, Dermatology Life Quality Index, Psoriasis Area and Severity Index, Nail Psoriasis Severity Index

scholarly journals Association of Nail Psoriasis With Disease Activity Measures and Impact in Psoriatic Arthritis: Data From the Corrona Psoriatic Arthritis/Spondyloarthritis Registry

2020 ◽  
pp. jrheum.190923
Author(s):  
Philip J. Mease ◽  
Mei Liu ◽  
Sabrina Rebello ◽  
Robert R. McLean ◽  
Blessing Dube ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Work Productivity ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Activity Impairment ◽  
Nail Psoriasis ◽  
Activity Measures

Objective To examine the association of nail psoriasis with disease activity, quality of life, and work productivity in patients with psoriatic arthritis (PsA). Methods 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, and work productivity at enrollment were compared between patients with vs without nail psoriasis using t-tests or Wilcoxon rank-sum tests for continuous variables and χ2 or Fisher exact tests for categorical variables. Results 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 P < 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 in Psoriatic Arthritis and Psoriatic Arthritis Disease Activity Score values, and increased likelihood of having enthesitis and dactylitis (all P< 0.05). Patients with nail psoriasis had worse pain, fatigue, and work and activity impairment than those without nail psoriasis (all P < 0.05). Conclusion Patients with PsA who have nail psoriasis had worse disease activity, quality of life, and work productivity than those without nail involvement, emphasizing the importance of identification and management of nail disease in patients with PsA.

scholarly journals The Impact of Nail Psoriasis and Treatment on Quality of Life: A Systematic Review

2021 ◽  
pp. 1-7
Author(s):  
Claire R. Stewart ◽  
Leah Algu ◽  
Rakhshan Kamran ◽  
Cameron F. Leveille ◽  
Khizar Abid ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Nail Psoriasis ◽  
Percent Improvement ◽  
Patient Reported ◽  
The Impact ◽  
Nail Involvement

At least 80% of patients with psoriasis will have nail involvement during their lifetimes. Understanding quality of life (QoL) impact of this condition and associated treatments is of utmost importance. Study objectives were to review the available literature describing patient-reported QoL outcomes in nail psoriasis and relationship with disease severity and treatment. A literature search was performed for English-language articles published prior to August 1, 2020. Articles were included in the review if primary data and validated patient-reported outcome measures assessing QoL were presented, and nail involvement was specifically examined. Fifteen studies were included in the final analysis. Patients with nail psoriasis had higher Psoriasis Area Severity Index and Dermatology Life Quality Index scores than those with psoriasis without nail involvement. The largest percent improvement in QoL score was associated with adalimumab. Studies investigating topicals, intralesionals, and systemic treatments were excluded since only biologic studies utilized validated patient-reported outcome measures. This review affirms that nail psoriasis is physically and emotionally distressing, warranting prompt treatment. Increased efforts are needed to address the impact of treatment on patient QoL using validated outcome measures that assess cosmetic, physical, and social problems.

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