Acroatrophy secondary to long-standing applications of topical steroids

Requena, L.

doi:10.1001/archderm.126.8.1013

Cited by 10 publications

(7 citation statements)

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“…Furthermore, a number of studies have documented a possible tapering of the treated digit, which is caused by atrophy of the underlying phalanx and is commonly known as ''disappearing digit.'' [57][58][59] Aside from these problems, other adverse effects include striae formation, development of telangectasias, tachyphylaxis, and potential systemic absorption of the steroid. With respect to the above studies, the only adverse reaction attributed to steroid application was seen in the investigation by Tosti et al, 55 in which there were 3 cases of erythema.…”

Section: Topical Therapymentioning

confidence: 99%

“…99,100 The chronic nature of the disease often requires repeated courses of the steroid, which can lead to reversible atrophy at the injection site 98,99 and potential atrophy of the underlying terminal phalanx, a condition known as ''disappearing digit.'' [57][58][59] Other complications, such as collagen atrophy and rupture of the extensor tendon, are only theoretical possibilities, because there are no well-documented cases of these events. 54 With respect to the needleless injectors, one study reported a puncture of the nail plate.…”

Section: Intralesional Therapymentioning

confidence: 99%

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Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

Jiaravuthisan

Sasseville

Vender

et al. 2007

Journal of the American Academy of Dermatology

364

382

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Section: Topical Therapymentioning

confidence: 99%

Section: Intralesional Therapymentioning

confidence: 99%

Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

Jiaravuthisan

Sasseville

Vender

et al. 2007

Journal of the American Academy of Dermatology

364

382

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“…[1] Furthermore, with persistent use of very potent topical steroids over years, a number of studies have documented a possible tapering of the treated digit, which can be caused by atrophy of the underlying phalanx and is commonly known as “disappearing digit”. [636465]…”

Section: Treatment Of Nail Psoriasismentioning

confidence: 99%

Nail psoriasis: The journey so far

Dogra

Arora

2014

Indian J Dermatol

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Nail involvement is an extremely common feature of psoriasis and affects approximately 10-78% of psoriasis patients with 5-10% of patients having isolated nail psoriasis. However, it is often an overlooked feature in the management of nail psoriasis, despite the significant burden it places on the patients as a result of functional impairment of manual dexterity, pain, and psychological stress. Affected nail plates often thicken and crumble, and because they are very visible, patients tend to avoid normal day-to-day activities and social interactions. Importantly, 70-80% of patients with psoriatic arthritis have nail psoriasis. In this overview, we review the clinical manifestations of psoriasis affecting the nails, the common differential diagnosis of nail psoriasis, Nail Psoriasis Severity Index and the various diagnostic aids for diagnosing nail psoriasis especially, the cases with isolated nail involvement. We have also discussed the available treatment options, including the topical, physical, systemic, and biological modalities, in great detail in order to equip the present day dermatologist in dealing with a big clinical challenge, that is, management of nail psoriasis.

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“…The formulation containing 8% clobetasol-17-propionate in colorless nail lacquer showed good clinical results and proved cosmetically highly acceptable for the treatment of nail bed and matrix psoriasis without joint involvement. 24 The side effects of corticosteroids, especially under occlusion and when applied for long periods, are skin atrophy and, rarely, if prolonged for more than a year, the atrophy of the underlying phalanx known as “disappearing digit”, 25 , 26 formation of striae and telangiectasia, tachyphylaxis, and systemic absorption. 6 …”

Section: Treatment Of Nail Psoriasismentioning

confidence: 99%

Optimal management of nail disease in patients with psoriasis

Piraccini¹,

Starace²

2015

PTT

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Psoriasis is a common skin disease, with nail involvement in approximately 80% of patients. Nail psoriasis is often associated with psoriatic arthropathy. Involvement of the nails does not always have relationship with the type, gravity, extension, or duration of skin psoriasis. Nail psoriasis can occur at any age and all parts of the nails and the surrounding structures can be affected. Two clinical patterns of nail manifestations have been seen due to psoriasis: nail matrix involvement or nail bed involvement. In the first case, irregular and deep pitting, red spots of the lunula, crumbling, and leukonychia are seen; in the second case, salmon patches, onycholysis with erythematous border, subungual hyperkeratosis, and splinter hemorrhages are observed. These clinical features are more visible in fingernails than in toenails, where nail abnormalities are not diagnostic and are usually clinically indistinguishable from other conditions, especially onychomycosis. Nail psoriasis causes, above all, psychosocial and aesthetic problems, but many patients often complain about functional damage. Diagnosis of nail psoriasis is clinical and histopathology is necessary only in selected cases. Nail psoriasis has an unpredictable course but, in most cases, the disease is chronic and complete remissions are uncommon. Sun exposure does not usually improve and may even worsen nail psoriasis. There are no curative treatments. Treatment of nail psoriasis includes different types of medications, from topical therapy to systemic therapy, according to the severity and extension of the disease. Moreover, we should not underestimate the use of biological agents and new therapy with lasers or iontophoresis. This review offers an investigation of the different treatment options for nail psoriasis and the optimal management of nail disease in patients with psoriasis.

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Acroatrophy secondary to long-standing applications of topical steroids

Cited by 10 publications

References 0 publications

Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

Nail psoriasis: The journey so far

Optimal management of nail disease in patients with psoriasis

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