2013
DOI: 10.1155/2013/180496
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Treatment of Nail Psoriasis: Common Concepts and New Trends

Abstract: The lifetime incidence of nail involvement in psoriatic patients is estimated to be 80–90%, and the nails can be affected in 10% to 55% of psoriatic patients. Psoriasis may also solely involve the nails, without any other skin findings, in which the treatment can be more challenging. Nail psoriasis may lead to considerable impairment in quality of life due to aesthetic concerns and more importantly limitations in daily activities resulting from the associated pain, which may be overlooked by the physicians. Se… Show more

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Cited by 41 publications
(31 citation statements)
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“…Moderate to severe nail psoriasis is characterized as severe nail dystrophy involving more than two nails, or disease accompanied with significant functional impairment or symptoms. Topical intralesional corticosteroids and topical vitamin D3 analogues are considered as first‐line therapy for mild disease . Calcipotriol or betamethasone dipropionate may be used as monotherapy, or as a combination .…”
Section: Introductionmentioning
confidence: 99%
See 1 more Smart Citation
“…Moderate to severe nail psoriasis is characterized as severe nail dystrophy involving more than two nails, or disease accompanied with significant functional impairment or symptoms. Topical intralesional corticosteroids and topical vitamin D3 analogues are considered as first‐line therapy for mild disease . Calcipotriol or betamethasone dipropionate may be used as monotherapy, or as a combination .…”
Section: Introductionmentioning
confidence: 99%
“…These topicals are generally well tolerated, though topical steroids have a well‐known side‐effect of causing atrophy. Other agents include topical tacrolimus, a non‐steroidal calcineurin inhibitor, and tazarotene, a third‐generation retinoid . For severe nail psoriasis, systemic therapy with anti‐tumor necrosis factor (TNF)‐alpha, biologic agents such as adalimumab, infliximab, etanercept and certolizumab pegol may be used.…”
Section: Introductionmentioning
confidence: 99%
“…Topical therapy, on the other hand, has a low success rate with currently available medicines, for example, 13-54% complete cure rates from amorolfine nail lacquer (Lauharanta, 1992;Paul et al, 2013;Reinel and Clarke, 1992), similarly low cure rates from ciclopirox nail lacquer (Gupta and Joseph, 2000), under 20% complete cure rate of efinaconazole solution (Tosti, 2013) and under 30% cure rate of tavaborole solution (Markham, 2014). Nail psoriasis affects approximately 1% of the population (Reich, 2009) and its treatment may involve repeated injections of corticosteroids into the nail folds, injections of biological agents such as adalimumab, photochemotherapy, topical or systemic treatment depending on the symptoms (Oram and Akkaya, 2013). The adverse effects of injections, photochemotherapy and systemic therapy, such as pain, radiation overexposure, systemic toxicity and drug interactions, make topical therapy very attractive; however topical management remains a challenge due to the low drug penetration through the nail plate.…”
Section: Introductionmentioning
confidence: 99%
“…1,2 Intralesional therapy includes triamcinolone acetonide and methotrexate 7 with less pronounced response. Both cause pain during injection.…”
Section: Discussionmentioning
confidence: 99%