A 14-year registry review (2007-2020) on nail involvement among patients with psoriasis in Malaysia.

Abstract

Nail psoriasis affects 20 to 30% of psoriasis patients and is an early predictor of psoriatic arthropathy (PsA). We have evaluated the prevalence, clinical characteristics, and impact on quality of life of patients with nail psoriasis. We conducted a multicenter retrospective cohort study was of patients registered with The Malaysian Psoriasis Registry (MPR) from 1 January 1, 2007 through 31 December 31, 2020. Of the 24147 patients, 13081 (54.2%) had nail psoriasis. Patients with nail psoriasis had la ater onset of psoriasis (34.0±16.6 vs 32.9±17.6 years, p<0.001) and longer disease duration (11.4±10.5 vs 8.5±9.4 years, p<0.01), with a male to female ratio of 1.2:1. They were more likely to have a family history of psoriasis, cardiometabolic diseases, smoking history, higher body mass index, severe disease, PsA, face and scalp involvement and higher mean Dermatology Life Quality Index scores (9.36±6.84 vs 8.87±6.60). Systemic treatment and biologics were more commonly prescribed in this cohort (25.0% vs 13.2%, p<0.001). Overall, 54.2% of the MPR patients had nail involvement. Nail psoriasis was associated with longer duration of psoriasis, older age of onset, male gender, and a family history of psoriasis. It proved to be an important predictor for PsA, severe psoriasis, face and scalp involvement, increased cardiometabolic risk, and a greater impairment of quality of life.