Psoriasis, Nails & Enthesopathy

Many Dermatological or skin diseases are associated with nail involvement. Such nail involvement may be associated with underlying disease in other organs. In particular the presence of nail psoriasis indicates that a patient may be at particular risk of developing Psoriatic Arthritis. The nail is directly inserted to the skeleton via entheses so the nail is part of an elaborate enthesis organ. This explains why patients with nail psoriasis may develop Psoriatic Arthritis. There is a link between psoriasis and skin injury or the so called "Koebner phenomenon." What have been described as "Deep Koebner phenomenon" occurs at the enthesis bone interface. Clinically silent abnormalities are common at such sites on imaging in Psoriasis patients. This section deals with aspects of enthesitis and enthesopathy relevant to Dermatology.

Enthesitis, Enthesopathy and the Nail in Psoriatic Arthritis

It has been recognised since the 1950's that nail disease is commoner in Psoriatic Arthritis than it is in Psoriasis. This is surprising since, during development, the nail is derived from the skin tissues, rather than joint tissues. It has also been shown that nail disease in subjects with ....

More »

Silent Arthritis and Enthesopathy in Patients with Psoriasis

Since enthesopathy is often the primary abnormality in Psoriatic Arthritis then it would be anticipated that enthesopathy would be present in psoriasis cases before the onset of arthritis and joint swelling. Since the 1970s numerous studies have shown skeletal changes in psoriasis ....

More »

Nail Anatomy and The Nail Enthesis

The nail is a tough hard shield on the extremities of the fingers and toes. It has several functions including: protection of the digits from trauma, a role in fine movements and pinching, a role in sensory perception, an emerging understanding of its role in skeletal function ....

More »

Arthritis Adjacent to Psoriatic Nail Disease

Patients with psoriasis often have joint pain. Psoriatic Arthritis tends to come on after age 40. Degenerative Arthritis or Osteoarthritis also tends to develop after age 40. Both Osteoarthritis and Psoriatic Arthritis have a tendency to afflict the distal ....

More »

Does Nail Related enthesopathy play a role in pincer nails?

The outside of the nail was thought to be anchored to the skin. Surgical dissection work and recent tissue histology studies have shown that the outside of the nail (lateral nail) is actually anchored to the ligament attachment sites ....

More »

Nail Disease and Arthritis Mutilans

Psoriatic Arthritis was first described in Leeds in 1956 by the late Professor Verna Wright. In the 1970s, with Dr John Moll, Wright classified Psoriatic Arthritis into 5 groups. These were: Asymmetric oligoarthritis, Symmetric polyarthritis, Psoriatic spondylitis with ....

More »