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

Jiaravuthisan, Michael M.; Sasseville, Denis; Vender, Ronald; Murphy, Francis; Muhn, Channy

doi:10.1016/j.jaad.2005.07.073

Cited by 361 publications

(433 citation statements)

References 106 publications

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“…Enthesitis and dactylitis, important distinguishing features of PsA in many patients, are associated with more severe disease; both can be difficult to treat and can lead to disability [5,13,31]. Approximately twice as many patients with PsA (21%) had nail involvement compared with patients with psoriasis alone (11%), and 44% of patients with PsA reported scalp involvement; however, overall these rates are lower than those previously reported [8,17,18,21,26]. The presence of skin disease in these areas has been found to have a disproportionate effect on QoL and is often difficult to treat, with limited effective treatment options [7,9,19,21].…”

Section: Discussionmentioning

confidence: 99%

Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey

2016

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Section: Discussionmentioning

confidence: 99%

Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey

2016

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“…The specific pathogenesis of psoriasis is not completly understood, but the underlyng mechanisms involve a complex interplay between epidermal keratinocytes, T limphocytes as well as other leukocytes, and vascular endothelium [3,4]. Even thought the skin lesions are the most typical manifestations of disease, nail involvement can be seen in up to 50% of psoriatic patients with a lifetime incidence of 80% to 90% [5,6]. Nail changes is seen in association with all types of psoriasis of the skin, and is frequently present with psoriatic arthropathy [7].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of nail abnormalities in patients with psoriasis

Ovčina-Kurtović¹,

Kasumagić-Halilovic²

2013

Our Dermatol Online

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Introduction: Psoriasis is a chronic inflammatory skin disease that affects about 2% of general population. Clinically, disease can present with cutaneous and nails lesions. Nail abnormalities can be seen in up to two-thirds of patients with psoriasis and both fingernails and toenails may be affected. Objective: The objectives of our study were to evaluate the frequency and clinical presentations of nail abnormalities in patients with psoriasis. Also, we aimed to find correlation between nail changes and some clinical parameters. Methods: One hundred and ten patients with psoriasis were included in this study. A detailed history and examination was recorded for all study subjects, including the age and gender of the patients, type of psoriasis, duration, and extent of disease. Finger and toe nails were clinically examined and nail changes were noted. In the case of clinically suspected of fungal infection, further mycological investigations were performed. Results: Nail abnormalities were present in 67 patients (60.9%) with psoriasis. Nail pitting was the most common lesion observed on fingernails, followed by discoloration of nail plate. Subungual hyperkeratosis of nail plates were significantly more frequent on the toenails. Positive mycological culture was in 14 (20.8%) psoriatic patients with nail involvement. Also, positive correlation between nail abnormalities and duration of psoriasis was found. Conclusions: Nail involvement is common in patients with psoriasis and accompanies skin lesions on the body surface. Pitting and subungual hyperkeratosis are the most frequent nail abnormality in psoriatic patients.

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“…These cuboidal cells are progressively flattened as they migrate, eventually losing their nuclei and condensing tightly into onychocytes, which become the nail plate. 12 Psoriatic involvement of the nail matrix causes aggregation of parakeratotic cells in the nail plate and other areas of the nail unit, thereby disrupting the normal process of keratinization and causing characteristic nail changes seen in psoriasis including pitting, leukonychia, crumbling, red spots in the lunula, transverse grooves, and trachyonychia. 13 These changes are summarized in Figure 2.…”

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confidence: 99%

“…This creates the tight adhesive bond holding the nail plate to nail bed, which continues from the eponychium to the hyponychium. 12 Psoriatic involvement of the nail bed leads to the development of onycholysis, salmon patches (oil drops), subungual hyperkeratosis, and splinter hemorrhages. 13 These changes are summarized in Figure 3.…”

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confidence: 99%

Clinical Manifestations and Management Considerations of Psoriasis Affecting The Nail Unit

Desai¹,

Rosso²,

Lebwohl³

2019

J of Skin

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Psoriasis is a chronic, inflammatory disease with a diverse array of clinical manifestations involving the skin, joints, and nails. Of these, nail psoriasis is a frequently overlooked, yet important complication of psoriasis which can cause significant physical and psychological distress to a patient. Psoriasis affecting the nail unit can pose both diagnostic and therapeutic challenges to physicians due to its clinical heterogeneity, the multitude of available treatment options, and the general lack of high-quality research on the subject. In order to aid the practicing clinician in appropriate diagnosis and treatment of nail psoriasis, this review provides an overview of the epidemiological, clinical, and pathophysiologic features of the disease, while also attempting to develop a rationale for effective medical management of the condition.

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

Cited by 361 publications

References 106 publications

Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey

Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey

Prevalence of nail abnormalities in patients with psoriasis

Clinical Manifestations and Management Considerations of Psoriasis Affecting The Nail Unit

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