SAT0599 FEET DERMATOLOGICAL CONDITIONS AND DEFORMITIES IN RHEUMATOID ARTHRITIS
Authors: S. M. Sánchez Romo, D. E. Flores Alvarado, J. C. López Zamarrón, M. A. Villarreal-Alarcón, I. D. J. Hernandez-Galarza, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2020)

Background: It has been extensively studied the repercussions of rheumatoid arthritis (RA) in hands and in their function. However, the evidence regarding the effect on feet and dermatological problems is scarce 1 . Objectives: Describe risk factors associated with foot deformities (FD) in patients with RA. Methods: This was a descriptive and observational cross-sectional study. Patients were consecutively recruited. Demographic-clinical data was registered and through physical examination the presence of FD, dermatological problems and pain location were assessed. The Foot Function Index (FFI) survey was used to measure foot functioning. Functional capacity was evaluated using the Health Assessment Questionnaire (HAQ) tool and quality of life with the Rheumatoid Arthritis Impact Disease (RAID) questionnaire. The risk of falling was calculated with Tinetti’s scale. An adjusted binary logistic regression was performed to compare patients with and without foot deformities. Models were adjusted for FFI’s, HAQ’s, RAID’s and Tinetti’s scores. Results: We included 76 subjects with RA with a mean age of 52.6 (11.40) years old. The 68.4% presented FD, while 69.7% had dermatological problems. Patients with FD were older (p=.005), had a more affected function of their feet (p=.002), greater risk of falling (p=.002) and worst functional capacity (p=.007) and quality of life (p=.026). Some factors that increased the risk of having FD in patients with RA were: age (OR 1.07, 95%CI: 1.001-1.147; p=.048), pain in toes and in the forefoot (OR 6.194; 95%CI: 1.172 – 32.743; p=.032) and having dermatological conditions in feet (OR 0.244; 95%CI: 0.067 –0.881; p=.031). Conclusion: Foot deformities and dermatological problems were present in more than the half of our sample. Older patients and subjects with dermatological problems and pain in toes and forefoot had a greater risk of presenting foot deformities. References: [1]A. Göksel Karatepe, et al. “Foot deformities in patients with rheumatoid arthritis: The relationship with foot functions,” Int. J. Rheum. Dis. , vol. 13, no. 2, pp. 158–163, 2010. Table 1. Demographic characteristics (n=76) Age, mean (SD) 52.605 +/- 11.40 Women, n (%) 76 (96.1) BMI*, median (IQR) 27.54 (24.00-30.38) Disease duration**, median (IQR) 96.00 (24.00 – 210.00) Diabetes mellitus, n (%) 19 (25.0) Arterial hypertension, n (%) 21 (27.6) DAS28-PCR, mean (SD) 2.99 (1.61) HAQ-score, median (IQR) 0.81 (0.25 – 1.47) RAID-score, median (IQR) 4.74 (3.06 – 7.52) FFI-score, mean (SD) 45.99 (27.37) Tinetti-score, median (IQR) 22.50 (10.00 – 45.50) Feet deformities , n (%) 52 (68.4) Hallux valgus, n (%) 38 (50) Claw toe, n (%) 23 (30.3) Hammer toe, n (%) 9 (11.8) Overlapping toes, n (%) 14 (18.4) Dermatological problems 53 (69.7) Ulcerations 1 (1.3) Plantar hyperkeratosis 30 (39.5) Plantar corn 6 (7.9) Onychomycosis 24 (31.6) Onychocryptosis 5 (6.6) Subungueal hematoma 1 (1.3) * kg/m 2 * *months Table 2. Comparison between presence and absence of foot deformities. Present n=52 Absent n=24 p Age, mean (SD) 54.88 (11.63) 47.66 (9.31) .005 Disease duration*, median (IQR) 120 (28.5-246) 54 (12-138) NS BMI**, median (IQR) 27.00 (23.95 – 30.40) 28.20 (25.01 – 31.68) NS DAS 28, mean (SD) 3.08 (1.61) 2.80 (1.64) NS FFI, mean (SD) 52.32 (24.78) 32.26 (28.18) .002 Tinitti’s scale, median (IQR) 37.50 (10.75 – 63.00) 12.00 (10 – 21.750) .002 HAQ, median (IQR) 1.19 (0.37 – 1.78) 0.565 (0.00 – 0.910) .007 RAID, median (IQR) 5.75 (3.46 – 7.52) 3.51 (1.27 – 6.81) .026 Pain location, n (%) .027 Absent 7 (13.46) 7 (29.16) NS Toes and forefoot 36 (69.23) 8 (33.33) NS Midfoot 2 (3.84) 1 (4.16) NS Rearfoot 7 (13.46) 8 (33.33) NS Pain intensity, mean (SD) 6.308 (3.01) 4.54 (3.50) .027 Dermatological problems, n (%) 42 (80.76) 13 (54.16) .003 *months ** kg/m 2 . NS: not significative. Disclosure of Interests: None declared