| Psoriatic nails | |
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| Classification and external resources | |
Psoriasis of a fingernail |
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Psoriatic nails is a nail disease. It is common in those suffering from psoriasis, with reported incidences varying from 10% to 78%. Elderly patients and those with psoriatic arthritis are more likely to have psoriatic nails.[1]:781-2
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[edit] Symptoms
- a translucent discolouration in the nail bed that resembles a drop of oil beneath the nail plate.[2]
- a thickening of the nail (normally at the tip) with ridges, pits and discolouration.
[edit] Diagnosis
The Nail Psoriasis Severity Index (NAPSI) is a numeric, reproducible, objective, simple tool for evaluation of nail psoriasis.[6]
There is a risk of misdiagnosis with onychomycosis.
[edit] Causes
The causes of nail psoriasis are unknown. It has been suggested that fungi may play a role.[7]
[edit] Treatment
There exist numerous treatments for nail psoriasis but there is little information concerning their effectiveness and safety.[8] Treatments include topical, intralesional, radiation, systemic, and combination therapies.
- Tacalcitol ointment[9] obtains a significant improvement in all nail parameters, both of the matrix and of the bed.
- Clobetasol nail lacquer and tacalcitol ointment[10]
- 5-fluorouracil. A reported side-effect is yellow nails[11]
- Calcipotriol[12]
- Calcipotriol plus betamethasone dipropionate ointment.[13]
- Efalizumab [14]
- Infliximab[15]
- Simponi.[16]
- intralesional steroid injection[17]
[edit] Relative effectiveness of treatments
Available studies lack sufficient power to extrapolate a standardized therapeutic regimen.[18]
- Infliximab appears to be the most effective treatment for nail psoriasis to date.[19]
- Results from low-dose acitretin therapy show NAPSI score reductions comparable with those studies evaluating biologic drugs for nail psoriasis and suggest that low-dose systemic acitretin should be considered in the treatment of nail psoriasis.[19]
[edit] Research
Active clinical trials investigating nail psoriasis:[20]
[edit] Phase IV
- Effects of Etanercept.[21]
- Effects of Simponi.[16]
[edit] Phase II
- Dose response and safety of topical Methotrexate.[22]
[edit] See also
[edit] References
- ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews’ Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
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- ^ NCT00265096
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- ^ doi:10.1002/14651858.CD007633
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- ^ clinicaltrials.gov
- ^ ClinicalTrials.gov NCT00581100
- ^ ClinicalTrials.gov NCT00666354
[edit] External links
| This Condition of the skin appendages article is a expanding it. |
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Source: Wikipedia
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