Nail psoriasis: a review of the literature

Schons, Karen Regina Rosso; Knob, Cristiane Faccin; Murussi, Nádia; Beber, André Avelino Costa; Neumaier, Walter; Monticielo, Odirlei André

doi:10.1590/abd1806-4841.20142633

Cited by 64 publications

(51 citation statements)

References 42 publications

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“…The same observations were communicated by Essayed et al [29]. According to literature data, the thickness of the nail bed could be a morphologic marker for a subclinical nail involvement and a good parameter for the evaluation of the therapeutic eicacy [46].…”

Section: Resultssupporting

confidence: 52%

Ultrasonography as a New, Non-Invasive Imagistic Technique Used for the Diagnosis and Monitoring of Psoriasis

Crışan¹,

Badea²,

Crişan³

et al. 2017

An Interdisciplinary Approach to Psoriasis

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Psoriasis is a chronic inlammatory autoimmune disease that involves the skin, nails, joints and other organs, being a systemic disease. Regardless of the clinical form, sonography can be efectively used to complete the clinical diagnosis. Aim:The identiication of non-invasive sonographic markers for the assessment of the severity of the disease and the eicacy of various therapies. Our study involved two research directions: (a) clinical and imagistic assessment of the skin and nail psoriasis lesions and (b) the imagistic evaluation of the therapeutic eicacy in psoriasis plaques and nail psoriasis by acquirement of sonographic images prior and after various therapies. Methods:In our prospective study, we used a multimodal evaluation of the disease, based on a non-invasive approach: clinical exam, dermoscopy, conventional and high frequency sonography, Doppler, power Doppler and elastography. Conclusions:Ultrasonography is an important tool for the non-invasive assessment of psoriatic lesions. It ofers speciic markers related to morphology, elasticity and blood supply of the lesions, improving the diagnosis and monitoring of the skin and nail lesions.

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Section: Resultssupporting

confidence: 52%

Ultrasonography as a New, Non-Invasive Imagistic Technique Used for the Diagnosis and Monitoring of Psoriasis

Crışan¹,

Badea²,

Crişan³

et al. 2017

An Interdisciplinary Approach to Psoriasis

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“…Despite new molecules discovered in the last two decades many patients remain untreated, do not respond or lose response, or suffer from treatment‐related side effects; in particular psoriasis affecting the nails, scalp, and palms can often be difficult to treat (Gisondi et al, ). Nail psoriasis affects 10–90% of adult patients with plaque psoriasis, and has been reported in 63–83% of patients with psoriatic arthritis (PsA; Schons et al, ). Nail involvement may place a significant burden on patients as a result of functional impairment of manual dexterity, pain, and psychosocial embarrassment.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of psoriatic crumbly nails with ustekinumab

Galluzzo

D’Adamio

Chimenti

et al. 2019

Dermatologic Therapy

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Nail involvement can place a significant burden on patients as a result of functional damage and psychosocial problems, leading to major repercussions on the quality of life. There is strong evidence that nail psoriasis can often be difficult to treat. We report a 69‐year‐old man with severe onychodystrophy, onycholysis, and pain in the hands; he had been previously treated with topical and systemic traditional therapies without satisfactory response. The patient showed multiple severe psoriatic crumbly nails (nail psoriasis severity index [NAPSI] score of 69) and started ustekinumab treatment at standard dosage of 45 mg fl.s.c. After 24 weeks, both nail matrix and nail bed disease showed marked improvement and the patient continued therapy with ustekinumab (NAPSI 0 at week 104). At week 136 (September 2015), the patient had been complaining of hands pain (visual analogue scale pain: 80) and ultrasonographic (US) evaluations found a synovial proliferation with effusion on metacarpophalangeal joints. The patient continued therapy with ustekinumab, adding methotrexate 10 mg fl.s.c/week. In November 2016, the patient showed a remission of symptoms; clinical and US evaluations did not find signs of synovitis. Methotrexate treatment was suspended and currently the patient reached more than 4 years of ustekinumab treatment without sign and symptoms of synovitis.

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“…Van Laborde et al have shown that there is an 80% to 90% lifetime incidence of nail involvement in psoriatic patients [4]. The presence of nail involvement of psoriasis is associated with an increase in patient-reported pain complaints, functional impairment and social burden, resulting in a significant restriction of daily activities and quality of life as well as resistance to treatment [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The microvascular and morphostructural changes of nails in psoriatic patients with nail disease; a link between ultrasound and videocapillaroscopy findings in the nailfold

Üreyen¹,

Kara²,

Ertürk³

et al. 2018

Med Ultrason

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Objective: The objective of this study is to evaluate the link between nail fold vessel resistive index (NVRI) measured by ultrasound (US) and capillary loops diameters measured using nailfold videocapillarascopy (NVC), and to assess the morphological appearance of the nail bed in patients with psoriatic nail disease (PND) as compared with healthy controls (HCs).Material and methods: This study was conducted in patients with PND and HCs. General demographic data were collected and clinical assessments were performed for all subjects. The nail plate thickness (NPT) was measured on gray scale using US. The NVRI was measured using color Doppler (CD) US. The measurements of the apical, arterial, venous limb diameters and morpho-structural changes (tortuous, cross-linked capillaries) were assessed using NVC.Results: Thirty-four patients with PND and 15 HCs were enrolled in this study. The two groups were matched for age and body mass index (BMI). Patients with PND had higher NPT and NVRI in comparison with HCs [(20 (17-23) vs 14 (14-15), p<0.001), (0.55 (0.51-0.61) vs 0.43 (0.38-0.49), p<0.001), respectively]. A higher proportion of patients with PND had tortuous capillaries than HCs (62% and 20% respectively, p=0.005). The mean NVRI was higher in patients with PND who had tortuous capillaries than patients who did not have tortuous capillaries (0.58 (0.7) and 0.52 (0.09), respectively p=0.033).Conclusion: Microvascular changes can be detected easily using non-invasive methods such as US and NVC. These methods can provide an objective data to better assess PND.

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Nail psoriasis: a review of the literature

Cited by 64 publications

References 42 publications

Ultrasonography as a New, Non-Invasive Imagistic Technique Used for the Diagnosis and Monitoring of Psoriasis

Ultrasonography as a New, Non-Invasive Imagistic Technique Used for the Diagnosis and Monitoring of Psoriasis

Successful treatment of psoriatic crumbly nails with ustekinumab

The microvascular and morphostructural changes of nails in psoriatic patients with nail disease; a link between ultrasound and videocapillaroscopy findings in the nailfold

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