Nail Fold Capillaroscopic Changes in Patients with Psoriasis and Psoriatic Arthritis

Introduction: Psoriasis and psoriatic arthritis (PsA) are systemic inflammatory diseases that affect both large vessels and the microcirculation. Nailfold capillaroscopy (NFC) offers a non-invasive tool to detect these vascular changes. This study aimed to identify nailfold capillaroscopic changes in patients with psoriasis and PsA. Methods: We conducted a case-control study including 40 patients with psoriasis (20 only with skin psoriasis, 20 with PsA associated with skin psoriasis) and 20 healthy controls. Demographic, clinical, and laboratory data were collected. Capillary density and morphology were assessed using NFC. Results: Capillary loop density was significantly lower in PsA patients compared to those with only psoriasis ( P ≤ .05). Both psoriasis and PsA groups showed a highly significant increase in rarefaction, avascularity, arterial limb diameter, and apical diameter compared to controls ( P ≤ .01). Capillary tortuosity was observed in 60% of psoriasis patients and 65% of those with PsA. Conclusion: NFC revealed characteristic microvascular abnormalities in psoriatic disease, supporting its value as a non-invasive tool for assessing systemic vascular involvement. Specific correlations with Psoriasis Area Severity Index score (PASI) and Disease Activity in Psoriatic Arthritis score (DAPSA) highlight its potential role in monitoring disease activity. Larger longitudinal studies are warranted to confirm these findings.