Analysis of Clinical and Metabolic Characteristics of Nail Damage in Patients with Psoriasis Vulgaris

Psoriasis vulgaris usually affects joints, skin and nails. The area of skin and joint damage has gradually gained clinical attention. A damage is often overlooked in clinical diagnosis and treatment. According to the study, 10% to 56% of patients with psoriasis have nail damage, and the proportion of patients with and only one lesion is as high as 1% to 10%.

Hand activity accounts for a large proportion of human activities, and psoriasis nail damage will also bring great psychological pressure to patients. Psoriasis nail damage not only affects the beauty of the hand but also greatly affects hand function, silver shavings. Damage to the disease can also cause great inconvenience to the patient’s family life and social activities.

To this end, 80 patients with psoriasis vulgaris were enrolled in this study. Demographic indicators, clinical and laboratory findings were collected, and the characteristics of A lesions, A lesions and clinical features, laboratory parameters and metabolic syndrome were analyzed. Relationship, the results are reported below.

1. Materials and methods of psoriasis vulgaris experiment

1.1 Materials

Eighty patients with psoriasis vulgaris admitted to our hospital from January 2014 to January 2016 were enrolled. Patients were included in the criteria: 1 patient and family informed consent; 2 patients aged ≥ 15 years. Exclusion criteria: 1 patient received treatment for nails in the past 3 months; 2 patients had artificial nails within 6 months; 3 patients had nail fungus disease or other related nail diseases; 4 analysis of patient’s nail damage and metabolism When the relationship between the laboratory and the laboratory is related, the patient has used immunosuppressive agents, glucocorticoids or acitretin within 1 month; 5 patients have cirrhosis, nephrotic syndrome and other diseases. Finally, 80 patients were selected for study and analysis.

1.2 Data collection

The patient’s demographic indicators and clinical laboratory findings were collected and recorded to calculate the patient’s body mass index (BMI) and psoriasis area. The patient’s obesity was defined as BMI≥25kg/m2; the patient’s age was ≤40 years old for early onset, and the patient was >40 years old for advanced onset; the patient’s disease duration ≤10 years was defined as short total disease duration, and the course of disease >10 years was defined as long total disease duration; The degree of classification PASI ≤ 10 is divided into mild to moderate, PASI > 10 is divided into severe; the lesion area of upper limb, lower limb, trunk and scalp is divided into 0, 1% to 9%, 10% to 29%, 30% to 49%. 50% to 69%, 70% to 89%, 90% to 100%.

1.3 Statistical processing

Data processing was performed using statistical software SPSS18.0. The measurement data conforms to the normal distribution by mean ± standard deviation (x ± s), the count data is expressed as a percentage (%); if it does not conform to the normal distribution, the median is used, and the non-parameter sum test is used. The rate was compared using the χ2 test, and the rank data was compared using the rank sum test. The categorical variable analysis uses the χ2 test, and the Pearson column contact number describes its two-variable correlation. The test level α=0.05, P<0.05 was considered statistically significant.

2. Results of psoriasis vulgaris experiment

2.1

Among the 80 patients with type A lesions, 38 (47.50%) had A lesions and 16 (20.00%) had nail damage. There were 22 cases (57.89%), 14 cases (36.84%), 13 cases (34.21%) and 11 cases (28.95) in patients with nail pit, hyperkeratosis, nail longitudinal ridge, nail stripping, oil nail and nail dystrophy. %), 5 cases (13.16%) and 1 case (2.63%).

2.2

The relationship between nail lesions in patients with psoriasis and clinical data characteristics of patients is shown in Table 1. Compared with patients without nail damage, patients with nail damage had longer course and more serious disease, and the difference was statistically significant (P<0.05). However, there was no nail damage and gender, age of onset, and family history. There were no significant differences in the differences (P>0.05).

2.3

The relationship between psoriasis nail damage and skin lesion area is shown in Table 2. There was a statistically significant difference in the area of skin lesions between the scalp, upper limbs, trunk and lower limbs in patients with or without nail damage. The proportion of lesions in the head, upper limbs, trunk and lower limbs of patients with nail damage was higher than that of patients without nail damage. (P<0.05). There was a correlation between nail damage and scalp lesion area (rcc=0.25, P=0.01), but no correlation with upper limb, trunk and lower limb lesion area (rcc=0.14, 0.16, 0.17; P>0.05).

2.4

The relationship between psoriasis nail damage and laboratory tests and metabolic indicators is shown in Table 3. Laboratory parameters (high white blood cells, elevated neutrophils, elevated lymphocytes), metabolic indicators (increased blood glucose, elevated glycated hemoglobin, elevated total cholesterol, triglycerides) among patients with or without nail damage There was no significant difference in the proportion of patients with elevated and elevated BMI (P>0.05).

3. Discussion of psoriasis vulgaris experiment

There are many cases of nail damage in patients with psoriasis. On the one hand, nail damage affects the appearance of the patient, and on the other hand, it is also a part of the complex inflammation of psoriasis, and it is necessary to pay sufficient attention to the treatment of psoriasis nail damage. Related literature has shown that the risk of arthritic psoriasis nail damage is significantly higher than other types of psoriasis patients, the prevalence of arthritic nail damage is as high as 70% to 80%, because psoriasis belongs to the immune system Disease, it is easy to cause joint pain and discomfort symptoms, psoriasis patients with rheumatoid arthritis-like joint damage, can affect the body size joints, but the end of the interphalangeal joint disease is the most characteristic. In the treatment of psoriasis, infliximab, etanercept, etc. have a significant effect, but the course of treatment is longer, all over 12 weeks, the effective way to find a treatment of psoriasis damage is the clinical focus task.

The results of this study found that 38 (47.50%) of the 80 patients had A lesions, which was consistent with the results of the relevant studies. The study found that patients with joint psoriasis had a higher risk of nail damage than the rest of the psoriasis patients. Psoriasis A damage mainly includes nail damage and nail bed damage. The former common damages include nail pit, nail malnutrition, nail longitudinal ridge, white nail, etc. The latter common damage includes oil nail, nail stripping, and lobular bleeding. , hyperkeratosis of the nail bed, and so on. The results of this study found that 80 patients with psoriasis vulgaris had a type of nail damage: hypertrophy, hyperkeratosis, nail longitudinal ridge, nail stripping, oil armor, and malnutrition in 22 patients (57.89 %), 14 cases (36.84%), 13 cases (34.21%), 11 cases (28.95%), 5 cases (13.16%) and 1 case (2.63%), of which the most common pits were hyperthyroidism. The second longitudinal ridge is the second, which is consistent with the conclusions of most studies.

Studies have found that there are more men than women with psoriasis in the presence of nail damage, and a higher proportion of family history of psoriasis in patients with nail damage, and patients with psoriasis who have no nail damage in this study. There were no statistically significant differences in gender and family history, which may be related to the small sample size of this study. However, this study shows that there is a close correlation between the damage of A and the duration of psoriasis and the severity of the disease. Compared with patients without A lesion, the proportion of psoriasis in patients with nail damage is higher than 10 years. And the proportion of patients with severe damage is higher, which is similar to the conclusions of some related studies. This part of the results suggests that nail damage can be used as one of the signs of exacerbation of psoriasis, which can provide a basis for early systemic treatment and prevent The condition continues to deteriorate. It has been reported in the literature that the larger the area of ​​psoriasis lesions, the higher the risk of arthritis associated with patients, and the higher the risk of nail damage. The results of this study found that there is no scalp or upper limb between patients with nail damage. The difference in skin lesions between the trunk and the lower limbs was statistically significant. The proportion of lesions in the head, upper limbs, trunk and lower limbs of patients with nail damage was higher than that of patients without nail damage. There was a correlation between nail damage and scalp lesion area, but no correlation with upper limb, trunk and lower limb lesion area.

It has been reported in the literature that the proportion of metabolic syndrome in patients with psoriasis is higher than that in normal healthy people. In this study, the relationship between psoriasis nail damage and laboratory and metabolic indicators was analyzed. The data showed that there was no nail damage. Among the patients, laboratory indicators (high white blood cells, elevated neutrophils, elevated lymphocytes), metabolic indicators (high blood sugar, elevated glycated hemoglobin, elevated total cholesterol, elevated triglycerides, BMI There was no significant difference in the proportion of patients with elevated disease. That is, this study did not find that there was a direct correlation between psoriasis nail damage and peripheral blood and metabolic indicators, and further research is needed.

In summary, patients with psoriasis vulgaris often have nail damage, which is closely related to the length of psoriasis and the severity of the disease. A lesion is related to the area of scalp lesion. However, there are still some limitations in this study. The sample size of psoriasis A damage is small, and it is still necessary to continue to collect, complete the in-depth study of large samples, and provide a large sample of evidence-based medical evidence for clinical treatment.