Nail psoriasis: clinical presentation and best practice recommendations.

Area of Science:

• Dermatology
• Rheumatology

Background:

• Nail psoriasis is a frequent complication of psoriasis vulgaris.
• It significantly diminishes patients' quality of life.
• Psoriatic nail dystrophy presents with various manifestations like pitting, onycholysis, and subungual hyperkeratosis.

Purpose of the Study:

• To review the current evidence on treatment options for nail psoriasis.
• To identify the efficacy and limitations of available therapeutic modalities.

Main Methods:

• Literature review of studies on nail psoriasis treatments.
• Analysis of topical, intralesional, phototherapy, and systemic treatment outcomes.
• Evaluation of treatment effectiveness for different nail dystrophy types.

Main Results:

• Topical corticosteroids and vitamin D(3) analogues show limited efficacy for all nail dystrophy types.
• Psoralen plus ultraviolet A (PUVA) improves some nail symptoms but not pitting.
• Systemic therapies, including biologics, are generally reserved for severe cases due to cost and toxicity.

Conclusions:

• Evidence for nail psoriasis treatment is insufficient, necessitating further research.
• Optimal therapeutic regimens for individual patients with psoriatic nail dystrophy remain to be determined.
• A comprehensive understanding of treatment efficacy is crucial for managing this condition.