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Fingernail changes correlate with severe systemic sclerosis

There was a high frequency of fingernail changes in patients with systemic sclerosis, and the changes were correlated with more severe forms of systemic sclerosis, according to study results published in the Journal of the American Academy of Dermatology.

Researchers in France conducted a case-control study of 129 patients (104 women; median age, 54 years) with systemic sclerosis and 80 healthy, age-matched control subjects (65 men; median age, 55 years). There was a median disease duration of 4.5 years, from onset of the first clinical manifestations of extra-Raynaud phenomenon.

The cohorts were compared for prevalence of fingernail changes, and patients with and without fingernail changes were compared.

Patients with systemic sclerosis had an 80.6% prevalence of fingernail changes. Trachyonychia (P = .006), brachyonychia (P =.0004), scleronychia , thickened nails, parrot breaking, pterygium inversum unguis, splinter hemorrhages and cuticle abnormalities (P < .0001, all) were more frequently exhibited in the patients with systemic sclerosis than in the healthy controls.

There was an association between digital ulcers (P < .0001), calcinosis cutis (P = .004), and higher values of mean nailfold videocapillaroscopy score (P = .0009) were associated with the presence of fingernail changes.

Study limitations included that the patient cohort originated from a single center, the researchers reported

“The current prospective case-control study showed a high frequency of fingernail changes in our population of 129 patients with [systemic sclerosis],” the researchers wrote. “Moreover, fingernail changes are correlated with more severe forms of [systemic sclerosis] characterized by digital microangiopathy, including digital ulcers and calcinosis cutis. Nail changes should be systematically checked in all patients with [systemic sclerosis], and may be included in the American College of Rheumatology/European League Against Rheumatism classification criterial for [systemic sclerosis].” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.