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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

AVALIAÇÃO DO ACOMETIMENTO UNGUEAL DE PACIENTES ADULTOS COM PSORÍASE VULGAR / EVALUATION OF NAIL INVOLVEMENT IN ADULT PATIENTS WITH PLAQUE-TYPE PSORIASIS

Schons, Karen Regina Rosso 03 June 2013 (has links)
Psoriasis is a chronic disease that presents in individuals of all ages, affecting skin, nails and joints. Nail changes are estimated to be present in 10-80% of psoriatic patients at some point in their lives, with consequent aesthetic and functional repercussions and quality of life impairment. In Brazil, there are only a few epidemiological studies on nail psoriasis (NP) so far. The aim of this study is to evaluate the nails of a sample of psoriatic patients from the south of Brazil, determining the prevalence of nail involvement, its main characteristics and clinical associations. This is a cross-sectional study that evaluated 65 outpatients with plaque-type psoriasis treated at the Hospital Universitário de Santa Maria - RS, from January 2012 to March 2013. Skin severity was evaluated using the PASI method and the nail changes were assessed using the NAPSI score. Psoriatic arthritis was determined by CASPAR criteria. Demographic variables were assessed by specific questionnaire. The prevalence of NP was 46.1%. Patients with NP had an average of 8.1±5 nails affected and the main morfological sign found was onycholysis (80%). Most patients (63.3%) reported functional or aesthetic discomfort related to nails involvement. When compared to patients without nail changes, patients with NP showed lower mean age of onset of psoriasis (27,6±14,9 vs. 42,7±15,9 years, p=0.001) and longer duration of the disease (17,5±10,7 vs. 9,1±9,7 years, p=0.003). Patients with NP also had higher PASI score (11,1±8,3 vs. 6,5±6,1, p=0.024), higher frequency of family history of psoriasis (40% vs. 7,4%, p=0.011) and higher frequency of psoriatic arthritis (43,3 vs. 3,7, p=0,002). The NP is still poorly studied, despite its clinical consequences such as pain, functional limitation and aesthetic disorders. Its importance as a predictor of joint involvement and more severe cutaneous disease was demonstrated by this study. Family history and early onset of disease were also associated with NP. / A psoríase, doença de curso crônico que afeta indivíduos de todas as idades, acomete pele, unhas e articulações. Estima-se que 10-80% dos pacientes apresentem alterações ungueais em algum momento de suas vidas, com consequentes repercussões estéticas, funcionais e na qualidade de vida. No Brasil, existem escassos estudos epidemiológicos sobre as formas ungueais até o presente momento. O objetivo deste estudo foi avaliar as unhas de uma amostra de pacientes portadores de psoríase, determinando a prevalência do acometimento ungueal, suas principais características e associações clínicas. Trata-se de um estudo transversal que avaliou 65 portadores de psoríase vulgar atendidos no Hospital Universitário de Santa Maria - RS, no período de janeiro de 2012 a março de 2013. Os pacientes tiveram seu quadro cutâneo quantificado pelo escore de PASI e o ungueal avaliado através do NAPSI. O diagnóstico de artrite psoriásica (AP) levou em conta os critérios de CASPAR. A prevalência de psoríase ungueal (PU) foi de 46,1%. Os portadores de PU tiveram em média 8,1±5 unhas acometidas e o principal sinal encontrado foi a onicólise (80%). A maioria dos pacientes (63,3%) relatou incômodo estético ou funcional associado ao quadro. Quando comparados aos pacientes sem acometimento ungueal, os pacientes portadores de PU apresentaram menor média de idade ao início da psoríase (27,6±14,9 vs. 42,7±15,9 anos, p=0,001) e maior tempo de evolução da doença (17,5±10,7 vs. 9,1±9,7 anos, p=0,003). Os pacientes com PU apresentaram também maior escore de PASI (11,1±8,3 vs. 6,5±6,1, p=0,024), maior frequência de relato de história familiar (40% vs. 7,4%, p=0,011) e de AP (43,3 vs. 3,7, p=0,002). A PU ainda é pouco estudada, apesar das consequências clínicas como dor e limitação funcional e dos transtornos estéticos. Sua importância como fator preditor de acometimento articular e de quadros cutâneos extensos foi demonstrada através deste estudo. A associação da PU com história familiar e início mais precoce da doença também foi significativa.

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