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Diseases of the Nails
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Management: Triamcinolone acetonide may be used by injecting 0.1 ml of 10 mg/ml into the nail fold or nail bed with regional or digital ring block. Other treatment options for nail psoriasis include topical corticosteroids (with or without occlusion), topical calcipotriol (with or without occlusion), topical tazarotene, acitretin, methotrexate, cyclosporine, phototherapy (e.g., PUVA), and the biologic agents.
Psoriasis
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Stamatis Gregoriou, Eftychia Platsidaki, Dimitris Rigopoulos
Nail psoriasis is the clinical manifestation of cutaneous psoriasis in the nail. It has significant impact on the patient, both functionally and psychologically. Nail psoriatic signs are present in 7%–56% of patients with cutaneous psoriasis. However, the lifetime incidence may be as high as 80%–90%. The prevalence of nail psoriasis without skin involvement or arthritis ranges from 1% to 6%. Nail lesions may appear several years later than cutaneous lesions, which may explain the fact that nail psoriasis is observed less frequently in children.
Topical Products Applied to the Nail
Published in Heather A.E. Benson, Michael S. Roberts, Vânia Rodrigues Leite-Silva, Kenneth A. Walters, Cosmetic Formulation, 2019
Apoorva Panda, Avadhesh Kushwaha, H.N. Shivakumar, S. Narasimha Murthy
Nail psoriasis is known to affect millions of people all around the world (Jefferson and Rich, 2012). The nail matrix, nail bed and nail folds are commonly affected by psoriasis, where the severity ranges from mild to extremely erythrodermic forms. A psoriatic nail displays a broad spectrum of symptoms varying from loosening of the nail plate, common pitting, hemorrhages and discolouration in the nail bed. The major signs of nail psoriasis include yellow-red discolouring, small pits in nails, thickening of skin under the nail, loosening and crumbling of the nail, and eventually nail loss (Jefferson and Rich, 2012). Nail psoriasis if left untreated can lead to functional impairment.
Lasers for the treatment of psoriasis: a systematic review
Published in Expert Review of Clinical Immunology, 2023
Kristine Heidemeyer, Mustafa Kulac, Andrea Sechi, Simone Cazzaniga, Luigi Naldi
The limitations of this review must be acknowledged. We did not perform a structured assessment of the quality of the evidence available. Only few RCTs were available, and a relevant proportion of trials were quite old, with missing information on relevant methodologic aspects such as blinding procedures or handling of drop-outs. Furthermore, the follow-up period was quite short in many trials evaluating nail psoriasis, compared to the slow growth of nail plate. Additionally, the studies were difficult to compare as heterogeneous outcome measures were reported and different endpoints were adopted. Therefore, also no meta-analysis could have been performed. In all the trials comparing lasers and topical treatments, there was no control about compliance of patients. In retrospective studies, there was a lack of explanation about patient selection criteria.
Safety of current systemic therapies for nail psoriasis
Published in Expert Opinion on Drug Safety, 2023
Jonathan K. Hwang, Shari R. Lipner
Nail psoriasis is a chronic inflammatory nail condition that may occur in isolation or in conjunction with psoriasis of the skin and/or joints [1]. Estimated nail involvement is up to 50% in patients with plaque psoriasis (PsO) and up to 80% in those with psoriatic arthritis (PsA) at any one time, with an overall lifetime incidence of 80–90% [2]. Nail symptoms may not always parallel that of cutaneous disease, with isolated nail involvement prevalent in 5–10% of all psoriasis patients [2]. Clinical manifestations of nail psoriasis include onycholysis, subungual hyperkeratosis, nail plate pitting, nail crumbling, salmon patches, leukonychia, and splinter hemorrhages [1,2]. Impact of nail psoriasis extends beyond esthetics, often resulting in negative impact on patient quality of life, including pain, functional impairment, and psychosocial concerns [3]. Prompt diagnosis and treatment of nail psoriasis is thus warranted, given its substantial disease burden as well as potential progression to PsA [4].
Topical calcipotriol plus betamethasone dipropionate for the treatment of plaque psoriasis: a drug evaluation
Published in Expert Opinion on Pharmacotherapy, 2021
Caitlin G. Purvis, Esther A. Balogh, Courtney E. Heron, Steven R. Feldman
Combination calcipotriol/BD contains a potent topical corticosteroid and is not indicated for use on sensitive areas (face, genitals, intertriginous regions) or in patients with erythrodermic, exfoliative, or pustular psoriasis or hypercalcemia [12,36]. The combination calcipotriol/BD, specifically the foam and ointment formulations, may be used to treat nail psoriasis for patients with few-nail disease and isolated nail matrix involvement [37,38]. The combination foam has greater efficacy for treating nail psoriasis compared to pulsed dye laser (PDL) [39]. Nail psoriasis has been associated with the comorbidity of psoriatic arthritis and is particularly important as the regulation authorities and insurers tend to include efficacy on nail psoriasis for the approval of new agents.