Nails are considered epidermal appendages, and as such, are commonly affected in
patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result
of their condition. Two patterns of nail disorders have been shown to be caused by
psoriasis. Nail matrix involvement can result in features such as leukonychia,
pitting (punctures or cupuliform depressions), red spots in the lunula and crumbling.
Nail bed involvement, on the other hand, can cause onycholysis, salmon or oil-drop
patches, subungual hyperkeratosis and splinter hemorrhages. Nail disease causes
aesthetic and functional impairment, and is indicative of more severe forms of
psoriasis as well as of joint involvement. The treatment for nail psoriasis involves
behavioral interventions, topical medications, or systemic therapy in case of
extensive skin or joint involvement. This article presents a review of the main
features of nail psoriasis, its clinical presentation, diagnostic and assessment
methods, clinical repercussions, and of its available treatment options.
Pyoderma gangrenosum is a chronic inflammatory dermatosis, which is associated with non-infectious systemic diseases such as rheumatoid arthritis and inflammatory bowel disease. It is more common in adults and may present with four distinct clinical forms, all leading to ulceration of the skin affected. Its diagnosis is clinical and demands exclusion of other causes. Treatment should be performed with local care and systemic therapy.
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