OCT imaging shows potential for psoriatic nail disease evaluation

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Recent studies by the Musculoskeletal Biomedical Research Unit at Leeds University NHS Trust, UK, indicate that Optical Coherence Tomography (OCT) has considerable potential for the evaluation of psoriatic nail disease.

An initial case study, published in Dermatology, compared nail bed images produced by the Michelson Diagnostics VivoSight OCT scanner with those produced using High Resolution Ultrasound.

The OCT images, which showed much higher-resolution changes than Ultrasound, correlated with the clinical observation of subungual hyperkeratosis.

Nail disease, which occurs in 10-55 per cent of patients with Psoriasis and in 53-86 per cent of patients with Psoriatic Arthritis, is increasingly recognised to be of major clinical and research relevance. As yet there are no objective methods to diagnose and assess nail disease in these patients.

These preliminary findings, which were also presented at a recent GRAPPA meeting (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) show that OCT has great potential for the systematic characterisation of nail changes in psoriasis and this could have implications for diagnosis, prognosis and monitoring of therapies and for a better understanding of nail disease pathogenesis.

The Leeds Psoriatic Arthritis Research Group, led by Prof Dennis McGonagle, is conducting further studies which will be published in the coming months.

Professor McGonagle stated: 'VivoSight offers unparalleled nail imaging capabilities that appear to have the same potential as microscopy for elucidating the microanatomical basis for nail disease. This could be key for predicting arthritis development in psoriasis cases and helping with timely treatment strategies.'

The VivoSight scanner uses OCT which provides images of sub-surface tissue similar to ultrasound, but at far higher resolution, enabling the clinician to see critical details in real time and without exposing the patient to ionising radiation. Michelson Diagnostics has already obtained CE mark and FDA clearance for clinical use of the scanner in Europe and USA, and it is being evaluated at leading research centres in Europe and USA.

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