Association of hypermobility and ingrown nails

Ingrown nail (onychocryptosis) is a common condition with severe pain and various associated morbidities. Although some underlying factors are identified, its etiology remains largely unknown. Generalized joint hypermobility (GJH) is a common entity with clinical features that might prone affected individuals to ingrown nails. Herein, we investigated the incidence of GJH in patients with ingrown nails to determine possible association between hypermobility and ingrown nail formation. Patients 16–50 years of age who were undergoing treatment for ingrown nails at the dermatology clinic were consecutively enrolled into the study. Patients with known rheumatic diseases or orthopedic foot disorders were excluded. All patients were in a pain-free period at the time of examination. The control group was comprised of age- and sex-matched healthy subjects without a history of ingrown nail. Assessment of GJH was made according to Beighton criteria. Local hypermobility was evaluated by measurement of range of motion using a goniometer. Thirty-nine patients (male/female, 17/22, mean age 31.9±11.3 years) and 32 healthy subjects (male/female 12/20, mean age 31.7± 10.4 years) were included. Patients with ingrown toe nails were more likely to have GJH compared to healthy subjects (35.9 vs. 9.4 %, p00.009). Toes with ingrown nails had significantly smaller maximum dorsiflexion angles (p< 0.001) compared to toes of healthy subjects. Ingrown nail formation may be associated with GJH. However, when examined locally, there is a limited range of motion in the affected toe rather than hypermobility, which could be due to the degenerative process facilitated by the hypermobility

Sterile Osteitis and Suppurative Arthritis Associated with Pannus Responding to Colchicine

Sterile suppurative arthritis is characterized by neutrophilic infiltration of joints without any causative pathogen. Here, we present a 32-year-old man with refractory osteitis and erosive suppurative oligoarthritis with pannus. Treatments with multiple disease modifying antirheumatic drugs were all unsuccessful. However, he had clinical response to colchicine and the synovial hypertrophy and the pannus in the MRI of his left shoulder resolved. In this case, the effects of colchicine on neutrophils might have played a role in treating neutrophilic sterile suppurative arthritis, which, in adults, might be a distinct oligoarticular disease

Decreased bone mineral density in adult familial Mediterranean fever patients: a pilot study

We investigated the association between familial Mediterranean fever (FMF) and osteoporosis (OP) in adult patients. Thirty-five attack-free FMF patients (28 females, 7 males; mean age 36.9 +/- 5.7 years) were individually matched to control subjects on the basis of age (within 2 years) and sex. All patients were taking regular colchicine. Subjects having any condition that can cause decreased bone mineral density (BMD) were excluded from the study. BMD was measured at the spine and femur by dual X-ray absorptiometry (DXA). Data was given as the median (IQR). T scores of the spine were -0.700 (-1.097 to -0.262) and -0.450 (-0.830 to 0.112) in FMF patients and healthy controls, respectively (p > 0.05). T scores of the femur neck were -0.900 (-1.480 to -0.570) and -0.430 (-1.472 to 0.247) in FMF patients and healthy controls, respectively (p > 0.05). Total femur T scores were significantly lower in FMF patients than healthy controls (-0.780 [-1.222 to -0.085] vs. -0.100 [-0.765 to 0.537], respectively, p = 0.021). Total femur T scores were significantly decreased in adult patients with FMF. Ongoing subclinical inflammation may be associated with decreased bone mineral content in those patients

Health-related quality of life and its associations with mood condition in familial Mediterranean fever patients

The aim of the present study was to investigate the health-related quality of life (HRQOL) and mood conditions in familial Mediterranean fever (FMF) patients. Ninety FMF patients (F/M 60/30, median age 29) and 67 control subjects (F/M 46/21, median age 30) were included in this study. HRQOL was assessed with short form-36 (SF-36) and mood conditions were assessed with hospital anxiety depression scale (HADS). FMF patients had significantly lower mean scores on SF-36 physical components compared to the control group. However, mental components were comparable between groups. FMF patients were significantly more likely to have depression and anxiety compared to the control group [30 (33%) vs. 8 (12%), respectively, chi (2) = 9.58, OR (95% CI) = 3.7 (1.5-8.7), p < 0.01 for depression and 48 (53%) and 11 (16%), respectively, chi (2) = 22.31, OR (95% CI) = 5.8 (2.7-12.5), p < 0.001 for anxiety]. When frequency of anxious subjects was adjusted for the presence of concomitant depressive status as a confounding factor, the difference between the groups remained statistically significant [chi (2) = 11.86, OR (95% CI) = 5.4 (2.1-13.7), p < 0.01]. However, the difference of depression status between groups was not statistically significant when adjusted for the presence of concomitant anxiety status [chi (2) = 0.08, OR (95% CI) = 1.3 (0.5-3.8), p = 0.78] and FMF was found to be independently associated with only anxiety [OR (95% CI) = 7.1 (2.3-20.3)]. In addition, pure anxious FMF subgroup had significantly lower scores of mental health and mental component summary when compared to normal mood subgroup. In conclusion, FMF might adversely affect HRQOL. Depression and anxiety are more frequent in FMF patients than healthy subjects

Serum Vitamin B12, Homocysteine and Methylmalonic Acid Levels in Patients With Parenchymal Neuro-Behçet's Syndrome.

This study aims to investigate the role of serum levels of vitamin B12 (VitB12), homocysteine (Hcy), and methylmalonic acid (MMA) in the development of parenchymal neuro-Behçet's syndrome (NBS) and to compare them with healthy controls and Behçet's syndrome (BS) patients without NBS

Differential diagnosis of elevated erythrocyte sedimentation rate and C-reactive protein levels: a rheumatology perspective.

In the case of high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, the diagnosis of the underlying disease can be challenging especially in serologically unrevealing patients who have nonspecific clinical findings. We aimed to investigate the final distribution of definitive diagnoses in patients who initially presented with nonspecific clinical findings and sustained elevations in serum ESR/CRP levels

Predictive value of neutrophil/lymphocyte ratio in renal prognosis of patients with granulomatosis with polyangiitis.

Granulomatosis with polyangiitis (GPA) is a rare necrotizing vasculitis, which usually involves the upper and lower respiratory systems and kidneys and often have a relapsing course. Neutrophil/lymphocyte ratio (NLR) has been shown to be a useful marker predicting not only progressive disease, but also mortality in various inflammatory diseases. We aimed to investigate the roles of NLR in predicting the extend of clinical involvement and prognosis of patients with GPA