Conflicts of interest This study was supported by research grants from Wyeth Pharma GmbH, Münster, Germany and from Essex Pharma GmbH, Munich, Germany. M.A., K.R. and M.A.R. have received funding from Wyeth Pharma GmbH and Essex Pharma GmbH for research and were invited speakers and consultants for both companies. C.B., I.S. and A.L. have no conflicts of interest to declare.
Nail psoriasis in Germany: epidemiology and burden of disease
Article first published online: 28 APR 2010
© 2010 The Authors. Journal Compilation © 2010 British Association of Dermatologists
British Journal of Dermatology
Volume 163, Issue 3, pages 580–585, September 2010
How to Cite
Augustin, M., Reich, K., Blome, C., Schäfer, I., Laass, A. and Radtke, M.A. (2010), Nail psoriasis in Germany: epidemiology and burden of disease. British Journal of Dermatology, 163: 580–585. doi: 10.1111/j.1365-2133.2010.09831.x
- Issue published online: 19 AUG 2010
- Article first published online: 28 APR 2010
- Accepted for publication 17 April 2010
- disease severity;
- health services research;
- nail psoriasis;
- quality of life
Background Although nail psoriasis affects a marked proportion of patients with psoriasis and causes significant psychological stress, only few epidemiological data characterizing patients with nail involvement are available.
Objectives To gain robust data on the epidemiology and disease burden of nail psoriasis in Germany.
Methods Two nationwide, noninterventional, cross-sectional studies on psoriasis health care were conducted in 2005 and 2007, involving 48 (2005) and 130 (2007) German office-based and clinic-based dermatological centres. Data of n = 3531 patients with psoriasis were collected using standardized questionnaires and physical examinations by trained dermatologists. Patients with nail psoriasis were compared with patients without any nail involvement concerning sex, age, disease duration, family history, disease severity, presence of psoriatic arthritis (PsA), health-related quality of life (HRQoL), number of inpatient therapies, and days off work.
Results Nail psoriasis was diagnosed in 40·9% of the patients; prevalence was 11·2 percentage points higher in men than in women. Patients with nail involvement had a longer disease duration (21·9 vs. 18·1 years), higher disease severity (mean Psoriasis Area and Severity Index 12·7 vs. 9·3), higher frequency of PsA (26·0% vs. 12·7%), stronger impairment of HRQoL (mean Dermatology Life Quality Index 8·9 vs. 7·3), and a 2·5-fold higher rate of inpatient treatments.
Conclusions Nail involvement is a relevant manifestation of psoriasis and is associated with a higher disease severity and quality of life impairment. Accordingly, management of psoriasis should include a special focus on nail involvement.