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Take a patient-specific approach to the treatment of nail psoriasis

  • Disease Management
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Abstract

Management of nail psoriasis requires an individualized approach, selecting treatments on the basis of disease severity, skin/joint involvement and patient preference. Treatment options include topical agents, intralesional corticosteroids, systemic agents, and photo, laser and radiation therapies. However, their use in nail psoriasis is based on limited data, and further research is needed to establish the optimal therapy.

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References

  1. Tan ES, Chong WS, Tey HL. Nail psoriasis: a review. Am J Clin Dermatol. 2012;13(6):375–88.

    Article  PubMed  Google Scholar 

  2. Tosti A, Piraccini BM, Cameli N, et al. Calcipotriol ointment in nail psoriasis: a controlled double-blind comparison with betamethasone dipropionate and salicylic acid. Br J Dermatol. 1998;139(4):655–9.

    Article  PubMed  CAS  Google Scholar 

  3. Rigopoulos D, Ioannides D, Prastitis N, et al. Nail psoriasis: a combined treatment using calcipotriol cream and clobetasol propionate cream. Acta Derm Venereol. 2002;82(2):140.

    Article  PubMed  CAS  Google Scholar 

  4. Tzung TY, Chen CY, Yang CY, et al. Calcipotriol used as monotherapy or combination therapy with betamethasone dipropionate in the treatment of nail psoriasis. Acta Derm Venereol. 2008;88(3):279–80.

    PubMed  Google Scholar 

  5. Scher RK, Stiller M, Zhu YI. Tazarotene 0.1% gel in the treatment of fingernail psoriasis: a double-blind, randomized, vehicle-controlled study. Cutis. 2001;68(5):355–8.

    PubMed  CAS  Google Scholar 

  6. Bianchi L, Soda R, Diluvio L, et al. Tazarotene 0.1% gel for psoriasis of the fingernails and toenails: an open, prospective study. Br J Dermatol. 2003;149(1):207–9.

    Article  PubMed  CAS  Google Scholar 

  7. Rigopoulos D, Gregoriou S, Katsambas A. Treatment of psoriatic nails with tazarotene cream 0.1% vs. clobetasol propionate 0.05% cream: a double-blind study. Acta Derm Venereol. 2007;87(2):167–8.

    Article  PubMed  CAS  Google Scholar 

  8. Fredriksson T. Topically applied fluorouracil in the treatment of psoriatic nails. Arch Dermatol. 1974;110(5):735–6.

    Article  PubMed  CAS  Google Scholar 

  9. de Jong EM, Menke HE, van Praag MC, et al. Dystrophic psoriatic fingernails treated with 1% 5-fluorouracil in a nail penetration-enhancing vehicle: a double-blind study. Dermatology. 1999;199(4):313–8.

    Article  PubMed  Google Scholar 

  10. Yamamoto T, Katayama I, Nishioka K. Topical anthralin therapy for refractory nail psoriasis. J Dermatol. 1998;25(4):231–3.

    PubMed  CAS  Google Scholar 

  11. Cannavo SP, Guarneri F, Vaccaro M, et al. Treatment of psoriatic nails with topical cyclosporin: a prospective, randomized placebo-controlled study. Dermatology. 2003;206(2):153–6.

    Article  PubMed  CAS  Google Scholar 

  12. de Berker DA, Lawrence CM. A simplified protocol of steroid injection for psoriatic nail dystrophy. Br J Dermatol. 1998;138(1):90–5.

    Article  PubMed  Google Scholar 

  13. Piraccini BM, Tosti A, Iorizzo M, et al. Pustular psoriasis of the nails: treatment and long-term follow-up of 46 patients. Br J Dermatol. 2001;144(5):1000–5.

    Article  PubMed  CAS  Google Scholar 

  14. Marx JL, Scher RK. Response of psoriatic nails to oral photochemotherapy. Arch Dermatol. 1980;116(9):1023–4.

    Article  PubMed  CAS  Google Scholar 

  15. Handfield-Jones SE, Boyle J, Harman RR. Local PUVA treatment for nail psoriasis. Br J Dermatol. 1987;116(2):280–1.

    Article  PubMed  CAS  Google Scholar 

  16. Oram Y, Karincaoglu Y, Koyuncu E, et al. Pulsed dye laser in the treatment of nail psoriasis. Dermatol Surg. 2010;36(3):377–81.

    Article  PubMed  CAS  Google Scholar 

  17. Fernandez-Guarino M, Harto A, Sanchez-Ronco M, et al. Pulsed dye laser vs. photodynamic therapy in the treatment of refractory nail psoriasis: a comparative pilot study. J Eur Acad Dermatol Venereol. 2009;23(8):891–5.

    Article  PubMed  CAS  Google Scholar 

  18. Tosti A, Ricotti C, Romanelli P, et al. Evaluation of the efficacy of acitretin therapy for nail psoriasis. Arch Dermatol. 2009;145(3):269–71.

    Article  PubMed  CAS  Google Scholar 

  19. Mahrle G, Schulze HJ, Farber L, et al. Low-dose short-term cyclosporine versus etretinate in psoriasis: improvement of skin, nail, and joint involvement. J Am Acad Dermatol. 1995;32(1):78–88.

    Article  PubMed  CAS  Google Scholar 

  20. Syuto T, Abe M, Ishibuchi H, et al. Successful treatment of psoriatic nails with low-dose cyclosporine administration. Eur J Dermatol. 2007;17(3):248–9.

    PubMed  Google Scholar 

  21. Feliciani C, Zampetti A, Forleo P, et al. Nail psoriasis: combined therapy with systemic cyclosporin and topical calcipotriol. J Cutan Med Surg. 2004;8(2):122–5.

    Article  PubMed  Google Scholar 

  22. Gumusel M, Ozdemir M, Mevlitoglu I, et al. Evaluation of the efficacy of methotrexate and cyclosporine therapies on psoriatic nails: a one-blind, randomized study. J Eur Acad Dermatol Venereol. 2011;25(9):1080–4.

    Article  PubMed  CAS  Google Scholar 

  23. Van den Bosch F, Manger B, Goupille P, et al. Effectiveness of adalimumab in treating patients with active psoriatic arthritis and predictors of good clinical responses for arthritis, skin and nail lesions. Ann Rheum Dis. 2010;69(2):394–9.

    Article  PubMed  Google Scholar 

  24. Rigopoulos D, Gregoriou S, Lazaridou E, et al. Treatment of nail psoriasis with adalimumab: an open label unblinded study. J Eur Acad Dermatol Venereol. 2010;24(5):530–4.

    Article  PubMed  CAS  Google Scholar 

  25. Korver JE, Langewouters AM, Van De Kerkhof PC, et al. Therapeutic effects of a 12-week course of alefacept on nail psoriasis. J Eur Acad Dermatol Venereol. 2006;20(10):1252–5.

    Article  PubMed  CAS  Google Scholar 

  26. Luger TA, Barker J, Lambert J, et al. Sustained improvement in joint pain and nail symptoms with etanercept therapy in patients with moderate-to-severe psoriasis. J Eur Acad Dermatol Venereol. 2009;23(8):896–904.

    Article  PubMed  CAS  Google Scholar 

  27. Reich K, Nestle FO, Papp K, et al. Infliximab induction and maintenance therapy for moderate-to-severe psoriasis: a phase III, multicentre, double-blind trial. Lancet. 2005;366(9494):1367–74.

    Article  PubMed  CAS  Google Scholar 

  28. Reich K, Ortonne JP, Kerkmann U, et al. Skin and nail responses after 1 year of infliximab therapy in patients with moderate-to-severe psoriasis: a retrospective analysis of the EXPRESS trial. Dermatology. 2010;221(2):172–8.

    Article  PubMed  CAS  Google Scholar 

  29. Patsatsi A, Kyriakou A, Sotiriadis D. Ustekinumab in nail psoriasis: an open-label, uncontrolled, nonrandomized study. J Dermatolog Treat. Epub 2011 Aug 8.

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Disclosure

This article was adapted from the American Journal of Clinical Dermatology 2012;13(6):375-88 [1] by Adis editors and medical writers. The preparation of these articles was not supported by any external funding.

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Adis Medical Writers. Take a patient-specific approach to the treatment of nail psoriasis. Drugs Ther Perspect 29, 82–87 (2013). https://doi.org/10.1007/s40267-013-0020-5

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  • DOI: https://doi.org/10.1007/s40267-013-0020-5

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