Uveitis and nail psoriasis in a patient without articular involvement: a case report

Juan Sebastián Pineda-Sierra; Luisa Fernanda Peña-Pulgar; Carlos Cifuentes-González; William Rojas-Carabali; Alejandra de-la-Torre

doi:10.1186/s12886-022-02596-4

Uveitis and nail psoriasis in a patient without articular involvement: a case report

Título traducido de la contribución: Uveítis y psoriasis ungueal en un paciente sin compromiso articular: reporte de un caso

Juan Sebastián Pineda-Sierra, Luisa Fernanda Peña-Pulgar, Carlos Cifuentes-González, William Rojas-Carabali, Alejandra de-la-Torre

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

Resumen

Fondo: Este estudio tuvo como objetivo reportar un caso de uveítis crónica no infecciosa no granulomatosa anterior bilateral asociada con psoriasis ungueal aislada sin afectación articular.
Presentación del caso: Un hombre de 55 años con antecedentes de glaucoma de ángulo abierto fue remitido a nuestro centro de uveítis e inmunología ocular por inflamación intraocular concordante con uveítis anterior no granulomatosa bilateral crónica no infecciosa. En el momento de la presentación presentaba inflamación moderada en la cámara anterior bilateral y lesiones características de psoriasis ungueal. La psoriasis ungueal fue confirmada posteriormente mediante ecografía ungueal realizada por un radiólogo especializado en psoriasis. Se realizaron evaluaciones clínicas y paraclínicas adecuadas, descartando todas las demás posibles causas de uveítis. El paciente requirió terapia inmunomoduladora sistémica dual con metotrexato y adalimumab, antiinflamatorios tópicos (esteroides y no esteroideos) y terapia antiglaucomatosa para lograr un control inflamatorio y de la presión ocular satisfactorio.
Discusiones y conclusiones: Este es el primer informe de uveítis no infecciosa asociada con compromiso ungueal en un paciente sin otras manifestaciones de psoriasis. A pesar de los informes sobre la relación entre la enfermedad psoriásica y la uveítis, no hay información suficiente sobre los fenotipos clínicos asociados con la uveítis que podrían conducir a un diagnóstico y tratamiento posterior de la inflamación intraocular asociada. Los médicos deben conocer todos los subtipos de psoriasis que aumentan el riesgo de desarrollar uveítis en estos pacientes.

Título traducido de la contribución	Uveítis y psoriasis ungueal en un paciente sin compromiso articular: reporte de un caso
Idioma original	Inglés estadounidense
Número de artículo	384
Páginas (desde-hasta)	1-5
Número de páginas	5
Publicación	BMC Ophthalmology
Volumen	22
N.º	384
DOI	https://doi.org/10.1186/s12886-022-02596-4
Estado	Publicada - sep. 24 2022

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Oftalmología

ODS de las Naciones Unidas

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title = "Uveitis and nail psoriasis in a patient without articular involvement: a case report",

abstract = "Background: This study aimed to report a case of bilateral anterior non-granulomatous chronic non-infectious uveitis associated with isolated nail psoriasis without articular involvement. Case presentation: A 55-year-old man with a history of open-angle glaucoma was referred to our uveitis and ocular immunology center with intraocular inflammation concordant with chronic non-infectious bilateral anterior non-granulomatous uveitis. At presentation, he had moderate inflammation in the anterior chamber bilaterally and lesions characteristic of nail psoriasis. Nail psoriasis was later confirmed by nail ultrasonography performed by a radiologist who specialized in psoriasis. Appropriate clinical and paraclinical assessments were conducted, ruling out all other possible causes of uveitis. The patient required dual systemic immunomodulatory therapy with methotrexate and adalimumab, topical anti-inflammatory drugs (steroidal and non-steroidal), and anti-glaucoma therapy to achieve satisfactory inflammatory and ocular pressure control. Discussion and conclusions: This is the first report of non-infectious uveitis associated with nail compromise in a patient without other manifestations of psoriasis. Despite reports on the relationship between psoriatic disease and uveitis, there is insufficient information on clinical phenotypes associated with uveitis that could lead to later diagnosis and treatment of associated intraocular inflammation. Clinicians should be aware of all subtypes of psoriasis that increases a risk of developing uveitis in these patients.",

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T2 - a case report

AU - Pineda-Sierra, Juan Sebastián

AU - Peña-Pulgar, Luisa Fernanda

AU - Cifuentes-González, Carlos

AU - Rojas-Carabali, William

AU - de-la-Torre, Alejandra

PY - 2022/9/24

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N2 - Background: This study aimed to report a case of bilateral anterior non-granulomatous chronic non-infectious uveitis associated with isolated nail psoriasis without articular involvement. Case presentation: A 55-year-old man with a history of open-angle glaucoma was referred to our uveitis and ocular immunology center with intraocular inflammation concordant with chronic non-infectious bilateral anterior non-granulomatous uveitis. At presentation, he had moderate inflammation in the anterior chamber bilaterally and lesions characteristic of nail psoriasis. Nail psoriasis was later confirmed by nail ultrasonography performed by a radiologist who specialized in psoriasis. Appropriate clinical and paraclinical assessments were conducted, ruling out all other possible causes of uveitis. The patient required dual systemic immunomodulatory therapy with methotrexate and adalimumab, topical anti-inflammatory drugs (steroidal and non-steroidal), and anti-glaucoma therapy to achieve satisfactory inflammatory and ocular pressure control. Discussion and conclusions: This is the first report of non-infectious uveitis associated with nail compromise in a patient without other manifestations of psoriasis. Despite reports on the relationship between psoriatic disease and uveitis, there is insufficient information on clinical phenotypes associated with uveitis that could lead to later diagnosis and treatment of associated intraocular inflammation. Clinicians should be aware of all subtypes of psoriasis that increases a risk of developing uveitis in these patients.

AB - Background: This study aimed to report a case of bilateral anterior non-granulomatous chronic non-infectious uveitis associated with isolated nail psoriasis without articular involvement. Case presentation: A 55-year-old man with a history of open-angle glaucoma was referred to our uveitis and ocular immunology center with intraocular inflammation concordant with chronic non-infectious bilateral anterior non-granulomatous uveitis. At presentation, he had moderate inflammation in the anterior chamber bilaterally and lesions characteristic of nail psoriasis. Nail psoriasis was later confirmed by nail ultrasonography performed by a radiologist who specialized in psoriasis. Appropriate clinical and paraclinical assessments were conducted, ruling out all other possible causes of uveitis. The patient required dual systemic immunomodulatory therapy with methotrexate and adalimumab, topical anti-inflammatory drugs (steroidal and non-steroidal), and anti-glaucoma therapy to achieve satisfactory inflammatory and ocular pressure control. Discussion and conclusions: This is the first report of non-infectious uveitis associated with nail compromise in a patient without other manifestations of psoriasis. Despite reports on the relationship between psoriatic disease and uveitis, there is insufficient information on clinical phenotypes associated with uveitis that could lead to later diagnosis and treatment of associated intraocular inflammation. Clinicians should be aware of all subtypes of psoriasis that increases a risk of developing uveitis in these patients.

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Uveitis and nail psoriasis in a patient without articular involvement: a case report

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