Nail Psoriasis: a Review of Current Topical and Systemic Therapies on ResearchGate, the professional network for scientists. Nail Psoriasis: a Review of Current Topical and Systemic Therapies. Title: Nail Psoriasis: a Review of Current Topical and Systemic Therapiesx. Systemic therapy is indicated when joint and skin disease warrant systemic treatment, or when nail disease causes significant disruption to quality of life.
This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. Nail psoriasis can be treated effectively using topical treatments, intralesional treatments, and systemic treatments, but an optimal effect may take up to 1 year. Despite its current popularity in nail psoriasis studies, the NAPSI has some disadvantages. Literature review current through: Mar 2016. Systemic therapy is typically reserved for patients with more extensive nail involvement and patients who fail to respond to topical therapy. The nails are often brittle and pits are present on palms and soles. A recent systematic review on treatment options for nail psoriasis, published in January 2013, highlighted the fact that the quality of trials done so far is generally poor and the data available is insufficient to advocate a consistent treatment approach or algorithm for the management of psoriasis.
Dermatology Research and Practice is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of dermatology. The lifetime incidence of nail involvement in psoriatic patients is estimated to be 80 90, and the nails can be affected in 10 to 55 of psoriatic patients. Several topical and systemic treatment modalities, as well as radiation and light systems, have been used in the treatment of nail psoriasis. The patient’s assessment of current disease severity – eg, using the static Patient’s Global Assessment. Third-line therapy which refers to systemic biological therapies that use molecules designed to block specific molecular steps important in the development of psoriasis, such as the TNF antagonists adalimumab, etanercept and infliximab, and ustekinumab, anti-IL12-23 monoclonal antibody. Topical use of potent corticosteroids on widespread psoriasis can lead to systemic as well as to local side-effects and the development of complications such as erythroderma or generalised pustular psoriasis. This review offers an investigation of the different treatment options for nail psoriasis and the optimal management of nail disease in patients with psoriasis. Keywords: biologics, nail psoriasis, topical therapy, systemic therapy.
Nail Psoriasis: A Review Of Treatment Options
Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. This article discusses the normal anatomy and embryology of the nail unit as well as the current understanding of the pathogenesis of the disease. Even though the current literature has shown some support for the use of topical, intralesional, radiation, systemic, and combination therapies for nail psoriasis, the available studies lack sufficient power to extrapolate a standardized therapeutic regimen. Psoriasis Online Medical Reference – from diagnosis through treatment. A clinical diagnosis is usually sufficient for classic skin and nail lesions. It may be used as monotherapy or in combination with topical or systemic therapies. Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. Current and relevant concepts in psoriatic arthritis (PDF). Topical therapies for the treatment of plaque psoriasis: systematic review and network meta-analyses. Keywords: Management, nails, palmoplantar, scalp, psoriasis. Topical treatment remains the first line of therapy for patients who present with an isolated involvement of these sites. However, in case of severe involvement of these sites or in patients who are refractory to topical therapy, systemic therapy is warranted. A Cochrane Review in 2006 on interventions for chronic PPP concluded that the ideal treatment for PPP remains elusive. Current Issue Archives Guidelines for Authors & Reviewers Classified Ads Links Search PubMed Subscriptions Subscriber Registration Guidelines for Website Users JRheum Update Service Contact Info Untitled Download PDF View Table of Contents. Medical management of nail psoriasis can be divided into the areas of topical, intralesional, radiation, and systemic and combination therapies. Systemic therapies such as methotrexate, retinoids, and ciclosporin are effective for patients with refractory or extensive cutaneous disease. Tazarotene gel, a recently developed topical retinoid for psoriasis, is available in 0. A sticky sensation to the skin, desquamation of the palms and soles, thinning of the nail plates, and development of pyogenic granulomas in paronychial areas can occur. Clinical pharmacology and pharmacokinetic properties of topically applied corticosteroids. A review.
Treatment Of Nail Psoriasis: Common Concepts And New Trends
For patients with mild psoriasis, candidates for topical therapy alone must meet all of the following criteria: generally asymptomatic; minimal impact on QoL; amenable and responsive to localised therapy; less than 5 for plaque psoriasis; and no incapacity and/or disability. The efficacy of therapies for psoriatic nail disease is not well studied; see table 2 for existing evidence. The array of disease manifestations coupled with the wide range in disease severity and course observed in PsA present formidable challenges to the treating clinician. Systematic review of treatments for psoriatic arthritis: an evidence based approach and basis for treatment guidelines. And sometimes changes in the nails can confirm a diagnosis of psoriasis. Treatments include some of the same topical and systemic therapies that are used to treat psoriasis that affects the skin. In some cases, medicines can be injected into the nail bed. Current as of: July 2, 2015. Healing of the psoriatic nails usually occurs when systemic therapy is initiated to treat severe skin psoriasis or joint involvement, but sometimes systemic therapy is essential for severe nail psoriasis, although Psoriasis Area and Severity Index (PASI) score is low or none of the joints are affected. Inflammatory Acne Vulgaris: Current Concepts in Pathogenesis and. BACKGROUND: Nails, one of the most visible sites of body, are frequently involved in psoriasis and accepted as the most difficult site for topical treatment because of their anatomical structure. Biological Properties of a New Volumizing Hyaluronic Acid Filler: A Systematic Review read.