Optical coherence tomography shows promise for assessing nail disease

10 August 2011

Recent studies by the Musculoskeletal Biomedical Research Unit at Leeds University NHS Trust, UK, indicate that optical coherence tomography has considerable potential for the evaluation of psoriatic nail disease.

Nail disease, which occurs in 10-55% of patients with psoriasis and in 53-86% 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.

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 Ultrasound1.

The OCT images which showed much higher-resolution changes than Ultrasound, correlated with the clinical observation of subungual hyperkeratosis (Fig 1 & 2 below) 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.

Fig 1: VivoSight OCT (1A) and ultrasound (1B) images of a healthy nail

Picture (2A), corresponding VivoSight OCT (2B) and US (2C) images of a psoriatic nail.

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.

Reference

1 Zehra, S. et al. Optical Coherence Tomography: A New Tool to Assess Nail Disease in Psoriasis?. Dermatology, DOI: 10.1159/000329434. S. Karger AG, Basel.

Source: Michelson Diagnostics