Arthritis ‘linked’ to skin condition

Around one in 50 people suffer from the skin condition psoriasis and as many as half go on to develop nail problems. These can leave patients in significant pain, cause disfigurement in nails and loss of function in small joints.

Doctors in Leeds were the first in the world to recognise in 1956 that some patients with psoriasis also go on to develop a specific type of arthritis, known as psoriatic arthritis.

This affects 10-20 per cent of psoriasis patients although it can take 20 years before it develops.

These patients are much more likely to suffer from nail disease compared to those with psoriasis alone, but there has been little work to assess it and how the disease progresses.

Now experts at the Musculoskeletal Biomedical Research Unit at Chapel Allerton Hospital in Leeds, which is a world-leading centre for work in the field, are using a high-tech scanner to examine nail changes.

The images allow doctors to assess potential abnormalities much earlier than using the naked eye and also offer better pictures than existing technology.

Prof Dennis McGonagle, who leads the Leeds Psoriatic Arthritis Research Group, said ultimately they wanted to identify which patients with psoriasis were likely to develop arthritis.

The state-of-the-art optical coherence tomography scanner, which was being trialled in Leeds, provided extremely high resolution images of nail damage which could help in better understanding its impact.

“This could be key for predicting arthritis development in psoriasis cases and helping with timely treatment strategies,” he said.

He said doctors were not at a stage where they could treat patients at risk of developing arthritis prior to symptoms developing, with a view to preventing it or slowing it down.

“Ultimately that is something that we are interested in, but it’s a question of how could we use our knowledge to identify who is going to get arthritis and then try to prevent it happening,” he said.