| Nail changes in connective tissue diseases: do nail changes provide clues for the diagnosis? | |
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MedLine Citation:
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PMID: 17373977 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the frequency and the specificity of nail changes associated with connective tissue diseases (CTD). METHODS: In a case-control study, 190 patients including those with systemic lupus erythematosus (SLE; 56), rheumatoid arthritis (RA, 47), primary Sjögren's syndrome (pSS; 35), systemic sclerosis (SSc; 39), and dermatomyositis/polymyositis (DM/PM; 13) were enrolled in the study. Patients with SLE and other CTDs were compared with two different control groups. Twenty nails were examined. Nail features were noted and classified. Nail samples were collected for mycological cultures. RESULTS: In patients with SLE, erythema of proximal nailfold (P<0.01), splinter haemorrhages in fingernails (P<0.01), capillary loops in proximal nailfold (P<0.05), periungual erythema (P<0.05), and thin nail plates (P<0.05) were more common than those in controls. Only splinter haemorrhages were associated with the disease activity. In patients with SSc and DM/PM, splinter haemorrhages (P<0.05) and capillary loops in proximal nailfold (P<0.01) in fingernails were common as well. Increase in longitudinal curvature (P<0.001), transverse curvature (P<0.01), and white dull colour in fingernails were other frequent findings in patients with SSc. Increase in transverse curvature was associated with the disease activity in SSc. In patients with RA, splinter haemorrhages (P<0.05), red lunula (P<0.05), and white dull colour (P<0.05) in fingernails were frequent. The sensitivity values of all these changes were very low. However, their specificity values were found to be relatively high. CONCLUSION: Proximal nailfold is the most important site of affection in CTDs. These nail changes can be used in combination with highly sensitive diagnostic modalities to establish an accurate diagnosis. |
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Authors:
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S E Tunc; I Ertam; T Pirildar; T Turk; M Ozturk; E Doganavsargil |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the European Academy of Dermatology and Venereology : JEADV Volume: 21 ISSN: 0926-9959 ISO Abbreviation: J Eur Acad Dermatol Venereol Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-03-21 Completed Date: 2007-07-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9216037 Medline TA: J Eur Acad Dermatol Venereol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 497-503 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Division of Rheumatology, Suleyman Demirel University, Isparta, and Internal Medicine Clinic, Section of Rheumatology, State Hospital, Denizli, Turkey. ercantunc@hotmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Arthritis, Rheumatoid / complications Capillaries / pathology Case-Control Studies Connective Tissue Diseases / complications*, diagnosis Dermatomyositis / complications Erythema / etiology Female Hemorrhage / etiology Humans Keratosis / etiology Lupus Erythematosus, Systemic / complications Male Middle Aged Nail Diseases / etiology* Nails / blood supply, pathology* Onychomycosis / complications Pigmentation Disorders / etiology Polymyositis / complications Scleroderma, Systemic / complications Sensitivity and Specificity Sjogren's Syndrome / complications |
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