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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Management of nail psoriasis.

L Thomas1, J Azad1, A Takwale2

  • 1Department of Dermatology, The James Cook University Hospital, Middlesbrough, UK.

Clinical and Experimental Dermatology
|August 3, 2020
PubMed
Summary
This summary is machine-generated.

Nail psoriasis affects most patients with psoriasis, causing pain and impacting quality of life. Effective treatments, including biologics, are available, though management remains challenging.

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Area of Science:

  • Dermatology
  • Rheumatology
  • Immunology

Background:

  • Nail psoriasis affects 80-90% of psoriasis patients, often indicating severe disease.
  • Nail involvement leads to pain, functional impairment, social stigma, and reduced quality of life.
  • Nail psoriasis is a risk factor for psoriatic arthritis (PsA).

Purpose of the Study:

  • To review current therapeutic options for nail psoriasis in adults and children.
  • To discuss management strategies for varying disease severity.
  • To highlight the need for simplified disease severity assessment.

Main Methods:

  • Literature review of existing studies on nail psoriasis treatments.
  • Analysis of therapeutic options including topical, systemic, and biologic agents.
  • Discussion of treatment efficacy for patients with and without co-existing skin psoriasis or PsA.

Main Results:

  • Topical treatments may benefit mild cases; systemic treatments are indicated for severe nail psoriasis.
  • Anti-tumour necrosis factor (TNF)-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies show high efficacy.
  • General advice includes nail care, protective gloves, and emollients.

Conclusions:

  • Nail psoriasis management is challenging but crucial due to its impact on quality of life and association with PsA.
  • Biologic therapies targeting TNF-α, IL-17, and IL-12/23 are effective for moderate to severe nail psoriasis.
  • Further research is needed for simplified clinical assessment tools and pediatric management guidelines.