Nail involvement in psoriatic arthritis

Area of Science:

• Dermatology
• Rheumatology
• Immunology

Background:

• Nail psoriasis affects quality of life and daily activities.
• It is prevalent in psoriasis vulgaris (50%) and psoriatic arthritis (80%).
• Nail changes predict psoriatic arthritis development.

Purpose of the Study:

• To review the clinical challenges and treatment strategies for nail psoriasis.
• To highlight the correlation between nail psoriasis and psoriatic arthritis.
• To discuss assessment tools and therapeutic options for nail psoriasis.

Main Methods:

• Literature review of nail psoriasis prevalence, impact, and treatment.
• Discussion of diagnostic and assessment tools like NAPSI, mNAPSI, and PNSS.
• Analysis of current therapeutic approaches, including systemic and topical treatments.

Main Results:

• Nail psoriasis presents diverse dystrophies, some mimicking other nail diseases.
• Assessment tools like NAPSI, mNAPSI, and PNSS aid in grading severity and evaluating treatment.
• Systemic therapies, especially biologics, show promise but have limitations.
• Topical therapy, particularly combined corticosteroids and vitamin D3 analogues, remains a primary treatment.

Conclusions:

• Nail psoriasis is a significant clinical challenge requiring tailored treatment.
• Effective management involves addressing dermal, articular, and ungual lesions.
• Combination topical therapy is a cornerstone for managing nail psoriasis.