Correlation of Nail Capillary Morphology with Metabolic Syndrome and Disease Severity in Psoriatic Patients

Abstract Background Capillaroscopy is a non-invasive technique which allows direct, in vivo imaging of skin microcirculation to detect microvascular abnormalities. An important association of psoriasis is metabolic syndrome, with a prevalence of 40% in psoriatic patients. Metabolic syndrome is a multiplex risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function. Patients with metabolic syndrome have an increased risk for cardiovascular diseases and atherosclerosis. Aim of the Work Describe the morphology, frequency and extent of nailfold capillary changes in psoriatic patients and identify patients’ characteristics possibly associated with such changes. Study if nail capillaroscopy can detect early endothelial dysfunction, occurring in psoriasis patients with metabolic syndrome, at the level of the dermal capillary microvasculature. Settings and Design cross-sectional study Materials and Methods Sixty five psoriasis patients were divided into two groups according to the presence or absence of metabolic syndrome. Naill capillaroscopy was done and compared between both groups. Results Psoriatic patients with metabolic syndrome showed significant differences in nail capillarascopy findings compared to those without metabolic syndrome, reflecting the greater endothelial dysfunction. Conclusion nail capillaroscopy can be a very important tool in detecting early endothelial dysfunction in psoriatic patients manifested by edema and tortuous capillaries. Moreover, it can reflect the degree of vascular compromise allowing proper identification of patients at high risk for cardiovascular events, which warrants aggressive early treatment