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    Association of pain and clinical factors on disability and quality of life in systemic sclerosis: A cross-sectional study from Turkish League Against Rheumatism Network
    (Turkish League Against Rheumatism, 2023) Cevik, Remzi; Em, Serda; Nas, Kemal; Toprak, Murat; Cengiz, Gizem; Calis, Mustafa; Sezer, Ilhan
    Objectives: In this study, we aimed to evaluate the factors associated with disability and quality of life (QoL) in Turkish patients with systemic sclerosis (SSc). Patients and methods: Between January 2018 and January 2019, a total of 256 SSc patients (20 males, 236 females; mean age: 50.9 +/- 12.4 years; range, 19 to 87 years) who were diagnosed with SSc were included in the study. Disability and health-related QoL (HRQoL) were evaluated by the Health Assessment Questionnaire (HAQ), scleroderma HAQ (SHAQ), Duruoz Hand Index (DHI), and Short Form-36 (SF-36). Linear regression analysis methods were used to describe factors associated with disability and QoL of the patients. Results: All disability scores were higher and HRQoL scores were lower in diffuse cutaneous SSc patients compared limited cutaneous SSc, and differentiations were significant (p= 0.001 and p= 0.007). In multiple regression, pain (VAS) was the strongest predictor for high disability and low QoL scores (p<0.001) as HAQ (beta=0.397, 0.386, 0.452), SHAQ (beta=0.397, 0.448, 0.372), DHI (beta=0.446, 0.536, 0.389), PCS (beta=- 0.417,- 0.499, -0.408) and MCS (beta=-0.478, -0.441, -0.370) in combined, lcSSc and dcSSc patients respectively. The factors associated with high disability and low QoL scores were forced vital capacity for HAQ (beta=- 0.172, p=0.002) and SF-36 PCS (beta= 0.187, p= 0.001); disease duration for HAQ (beta=0.208, p<0.001), DHI (beta=0.147, p=0.006), and SF-36 PCS (beta=-0.134, p= 0.014); 6-minute walk test for HAQ (beta=- 0.161, p= 0.005) and SF-36 PCS (beta= 0.153, p=0.009); and modified Rodnan skin score for SHAQ (beta= 0.250, p<0.001) and DHI (beta=0.233, p<0.001) in SSc patients. Diffusing capacity of the lungs for carbon monoxide for HAQ (beta=- 0.189, p=0.010) and SHAQ (beta=-0.247, p= 0.002); erythrocyte sedimentation rate for DHI (beta=0.322, p<0.001); age for SF-36 PCS (beta=-0.221, p=0.003) and body mass index for SF-36 PCS (beta=-0.200, p=0.008) and MCS (beta=-0.175, p=0.034) were the other variables associated with high disability or low QoL scores in SSc subsets. Conclusion: Clinicians should consider the management of the pain and its sources as a key to improve better functional state and quality of daily life in SSc.
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    The impact of nail psoriasis on disease activity, quality of life, and clinical variables in patients with psoriatic arthritis: A cross-sectional multicenter study
    (Wiley, 2023) Cengiz, Gizem; Nas, Kemal; Keskin, Yasar; Kilic, Erkan; Sargin, Betul; Kasman, Sevtap Acer; Alkan, Hakan
    Aim Nail involvement is common in psoriatic arthritis. This study assesses clinical characteristics, nail psoriasis prevalence, and impact of nail psoriasis on disease activity in patients with psoriatic arthritis (PsA). Method This cross-sectional multicenter study was conducted by the Turkish League Against Rheumatism using PsA patients recruited from 25 centers. Demographic and clinical characteristics of PsA patients, such as disease activity measures, quality of life, and nail involvement findings were assessed during routine follow-up examinations. Patients were divided into two groups according to the presence or absence of nail psoriasis and compared using the chi(2) test or Fisher exact test for categorical variables and the t-test or Mann-Whitney U test for continuous variables. Results In 1122 individuals with PsA, 645 (57.5%) displayed nail psoriasis. The most frequent features of fingernails were ridges (38%), followed by pitting (21%) and onycholysis (19%). More females were present in both groups (with and without nail psoriasis; 64% vs 67%, P < 0.282). Patients with nail psoriasis were older, indicated more pain and fatigue, experienced greater swelling, tender joint counts, and skin disease severity, and had a higher disease activity score compared with those without nail psoriasis (all P < 0.05). Conclusion We demonstrate an increased prevalence of nail psoriasis observed in patients with psoriatic arthritis. Patients with nail involvement experience increased disease activity, lower quality of life, and diminished mental and physical status compared with those without nail involvement.