Nail Psoriasis: A Review of Treatment Options

Pasch, Marcel C.

doi:10.1007/s40265-016-0564-5

Cited by 123 publications

(156 citation statements)

References 159 publications

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“…In the same study,patients treated with cyclosporine showed a 37% mean improvement in the NAPSI score (21 (25). The efficacy of etanercept in nail psoriasis has also been supported by other studies (7,26,27). In our case, there was a rapid response to etanercept with a significant reduction in the NAPSI score.…”

Section: Case Reportsupporting

confidence: 84%

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Therapeutic challenges in a case of psoriasis with nail onset

Mitran¹,

Mitran²,

Sârbu³

et al. 2017

J Mind Med Sci.

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Nail psoriasis affects a large number of patients with psoriasis and has a major psychosocial impact. Furthermore, it may be regarded as a predictor of more severe forms of psoriasis and early sign of psoriatic arthritis. The clinical presentations vary depending on the structure affected (nail matrix or nail bed), the nail lesions may range from minor to severe, but they are not specific. Treatment is a challenge, in most cases the lesions being resistant to therapy. We present a rare case of psoriasis with nail onset in a 59-year-old woman. The nail involvement confined to the fingernails was severe, with significant impairment of the patient's quality of life. Conventional therapies failed to improve the nail lesions, but a marked improvement was achieved under etanercept therapy.Acne conglobata is a rare, severe form of acne vulgaris characterized by the presence of comedones, papules, pustules, nodules and sometimes hematic or meliceric crusts, located on the face, trunk, neck, arms and buttocks. Case ReportWe report the case of a 16 year old Caucasian female patient from the urban area who addressed our Mădălina I. Mitran et al.

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Section: Case Reportsupporting

confidence: 84%

“…Nail pitting is the most common sign encountered in nail psoriasis (6)(7)(8). These changes are not specific and may also occur in other disorders (9).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic challenges in a case of psoriasis with nail onset

Mitran¹,

Mitran²,

Sârbu³

et al. 2017

J Mind Med Sci.

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“…Manifestations were symmetric polyarthritis in more than five joints (fingers, toes, wrists, ankles, knees, elbows and shoulders), with lesions mimicking rheumatoid arthritis. [1][2][3][4] There were also right sternoclavicular arthritis and enthesitis of Achilles tendons. 4 Psoriasis can significantly affect the functional, psychological and social well-being of the patients, causing at least moderate effect on the quality of life in 43.2% of individuals.…”

Section: Psoriatic Arthritismentioning

confidence: 99%

“…4 Psoriasis can significantly affect the functional, psychological and social well-being of the patients, causing at least moderate effect on the quality of life in 43.2% of individuals. 3,5 Psoriasis is a chronic inflammatory condition with an estimated prevalence of 0.7 to 8.5%, which often affects extensor areas of the limbs, scalp, umbilicus and lumbar regions. [1][2][3][4][5] The major risk factor of susceptibility to the early onset psoriasis is HLA-Cw6 on chromosome 6; and the cytokines involved in the etiopathogenesis of psoriatic cutaneous alterations are tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-17A, IL-17F, IL-22, IL-26, IL-23, IL-20, and IL-15.…”

Section: Psoriatic Arthritismentioning

confidence: 99%

“…3,5 Psoriasis is a chronic inflammatory condition with an estimated prevalence of 0.7 to 8.5%, which often affects extensor areas of the limbs, scalp, umbilicus and lumbar regions. [1][2][3][4][5] The major risk factor of susceptibility to the early onset psoriasis is HLA-Cw6 on chromosome 6; and the cytokines involved in the etiopathogenesis of psoriatic cutaneous alterations are tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-17A, IL-17F, IL-22, IL-26, IL-23, IL-20, and IL-15. 1,3 Nails changes occur in up to 90% of psoriatic patients and are more common and severe in individuals with joint involvement, affecting: i) nail matrix (pitting, leukonychia, red spots of the lunula, transverse grooves (Beau's lines)), and crumbling of the nail plate; and ii) nail bed (oil-drop discoloration, splinter hemorrhages, subungual hyperkeratosis, and onycholysis.…”

Section: Psoriatic Arthritismentioning

confidence: 99%

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An old woman with chronic palmar dermatosis, rheumatism, and nail changes

Santos

Pedrosa²,

Ferreira

et al. 2017

Ital J Med

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This 71-year-old Brazilian woman was admitted because of asthenia, palpitations, progressive breathlessness, and paroxysmal nocturnal dyspnea in the last three months. She also complained of a constrictive precordial pain irradiating to dorsum, fatigue and morning hand stiffness. Seven days before admission the cardiac scintigraphy showed discrete contractility changes. Medical antecedents were dermatosis over than 10 years, and rheumatism nearly 8 years; and intermittently used deflazacort, non-steroidal anti-inflammatory drug (NSAID), and methotrexate with good clinical response. She denied occurrence of fever, anorexia, loss of weight, and urinary changes; but presented one episode of melena first attributed to acute mucosal lesions due to medicines. However, both upper digestive endoscopy and colonoscopy evaluations were unremarkable. Physical examination revealed body mass index: 28 kg/m 2 ; and vital signs were temperature: 36.5°C, blood pressure: 110/70 mmHg, heart rate: 78 beats/min, and respiratory rate: 16 breaths/min. There were bilateral ulnar deviation of the wrists, painful hypertrophic changes in the interphalangeal joints and in the right sternoclavicular joint, and pain in the Achilles tendons. Moreover, bilateral palmar patches with lamellar desquamation; pitting, transverse grooves, and some transverse over curvature were detected in hands nails (Figure 1). Laboratory determinations showed hemoglobin: 11.5 g/dL, hematocrit: 37.1%, leukocytes: 5198/mm 3 , platelets: 105,000/mm 3 , erythrocyte sedimentation rate: 41 mm/h, C-reactive protein: 0.4 mg/dL, rheumatoid factor: 11 IU/mL, anti-nuclear antibody (immunofluorescence on HEp-2 cells): negative, triglycerides: 93 mg/dL, total cholesterol: 170 mg/dL, high-density lipoprotein cholesterol: 43 mg/dL, low-density lipoprotein cholesterol: 108 mg/dL, iron: 66 mcg/dL, albumin: 3.9 g/dL, globulins: 2.7 (α1: 0.2, α2: 0.5, β1: 0.6, β2: 0.5, γ: 0.9) g/dL, vitamin D: 14.6 ng/mL, immunoglobulin (Ig) G: 978 mg/dL, IgM: 177.9 mg/dL, transferrin: 357 mg/dL, transferrin saturation: 15%, glycated hemoglobin: 5.6%, potassium: 3.7 mmol/L, urea: 18.3 mg/dL, creatinine: 0.65 mg/dL, alanine aminotransferase: 46.6 IU/L, aspartate aminotransferase: 57.2 IU/L, thyroid-stimulating hormone: 1.53 mcIU/mL, free T4: 0.9 ng/dL, serologic tests for HIV and viral hepatitis: negative. The bone scintigraphy study showed hypercaptation in her shoulders, elbows, ABSTRACTPsoriasis is a chronic inflammatory condition with variable changes on the skin and nails, sometimes associated with osteoarticular manifestations characterizing the psoriatic arthritis. This arthritis may precede, follow, or be concomitant with the skin lesions of psoriasis. Unsuspected psoriatic arthritis may be misdiagnosed by other seronegative spondyloarthritis, mainly in primary care attention, and ominous outcomes are related to late and inadequate management. Therefore, diagnostic exercises with base on significant clinical and radiological images might contribute to enhance the suspicion index about these...

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Psoriasis for the primary care practitioner

Young

Aldredge

Parker

2017

Journal of the American Association of Nurse Practitioners

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Primary care practitioners (PCPs) are playing an increasingly important role in the management and care of psoriasis. Thus, it is important for PCPs to be knowledgeable about the disease and to be able to differentiate between common myths and facts related to diagnosis and treatment. By building relationships with their patients and working collaboratively with dermatology health professionals and other specialists, PCPs can facilitate communication about the patient's treatment preferences and expectations for symptom relief, and they may be better able to work with the patient to optimize treatment adherence. This review aims to provide PCPs with a primer on psoriasis, its associated comorbidities, and its impact on patients’ quality of life. Discussion topics include psoriasis epidemiology, triggering factors, clinical presentation, differential diagnosis, comorbidities, and approaches to treatment. This review also highlights the importance of staying abreast of advances in the understanding of psoriasis pathogenesis as well as emerging therapeutic treatment options, because these advances may change the treatment landscape and increase patients’ expectations for skin clearance.

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Nail Psoriasis: A Review of Treatment Options

Cited by 123 publications

References 159 publications

Therapeutic challenges in a case of psoriasis with nail onset

Therapeutic challenges in a case of psoriasis with nail onset

An old woman with chronic palmar dermatosis, rheumatism, and nail changes

Psoriasis for the primary care practitioner

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