The clinical features of nail psoriasis are extremely variable and depend upon the site affected. It is characterized by destructive pustulation of the nail unit which may occur as a part of pustular psoriasis, palmoplantar pustulosis, 29 and acrodermatitis continua of Hallopeau. Tazarotene as alternative topical treatment for onychomycosis. Given the well-documented efficacy of tazarotene on hyperkeratotic nail psoriasis, we investigated its therapeutic use in onychomycosis. 18 The latter appear dysregulated in genetic diseases, such as pachyonychia congenita and focal palmoplantar keratoderma.18 As a matter of fact, fungal infections could exacerbate or predispose an individual to pachyonychia congenita. The main topical treatments for nail psoriasis have traditionally comprised potent corticosteroids applied under occlusion. In a RCT of palmoplantar psoriasis, 28 of 36 patients with nail involvement received adalimumab therapy for 16 weeks and showed a higher mean percentage of NAPSI improvement compared to placebo-treated group (50 versus 8 ).
Tazarotene has also been found to be efficacious in combination with topical steroids and calcipotriol. Patients with nail psoriasis can develop a wide variety of nail ch. Pityriasis rubra pilaris Pityriasis rubra pilaris (PRP) is an uncommon skin disorder that most commonly presents with hyperkeratotic follicular papules, orange-red plaques, and palmoplantar hyperkeratosis. In addition to these randomized trials, uncontrolled studies and case series report efficacy of treatment with once-daily calcipotriol/betamethasone dipropionate ointment 25, weekday calcipotriol treatment combined with weekend clobetasol therapy 26, and twice-daily topical calcipotriol monotherapy 27. Tazarotene also reduced nail pitting when used under occlusion. Keywords: Management, nails, palmoplantar, scalp, psoriasis. Tazarotene has also been found to be efficacious in combination with topical steroids and calcipotriol.
Childhood nail psoriasis: a useful treatment with tazarotene 0.05. Therapeutic effect on plaque, palmoplantar and nail psorasis, by restoring normal keratinocyte proliferation and lowering epidermal inflammation. 0.1 tazarotene appears to be as efficacious as 0.05 tretinoin in this respect. Topical tazarotene is also effective in treating psoriasis of the nails (nail psoriasis) and psoriasis of the hands and feet (palmoplantar psoriasis). Handa, Newer trends in the management of psoriasis at difficult to treat locations: scalp, palmoplantar disease and nails, Indian Journal of Dermatology, Venereology and Leprology, vol.
Newer Trends In The Management Of Psoriasis At Difficult To Treat Locations: Scalp, Palmoplantar Disease And Nails Handa S
Treatment options for moderate to severe psoriasis include topical and systemic medications, phototherapy, and excimer laser, Combination therapies are often more effective than one treatment alone. Over half of patients with psoriasis have abnormal changes in their nails, which may appear before other skin symptoms. When they form on the palms and soles, the condition is called palmar-plantar pustulosis. Tazarotene may cause dryness and irritation of healthy skin. The study authors felt treatment of the nail disease is more of an arthritis issue than a dermatological issue. In plaque and palmoplantar psoriasis, the three pathogenic factors that we want to resolve are abnormal keratinocyte differentiation, epidermal hyperproliferation and inflammation of the skin. Angelo JS, Kar BR, Thomas J. Comparison of clinical efficacy of topical tazarotene 0.1 cream with topical clobetasol propionate 0. Nail psoriasis is difficult to treat, but may respond to some treatments. We aimed to review the efficacy and safety of the treatments used for nail psoriasis. Treatments for chronic palmoplantar pustulosis (a skin disease where repeated crops of painful yellow pus spots form on the palms and soles). Any involvement of nails, high-impact and difficult-to-treat sites (eg, the face, scalp, palms, soles, flexures and genitals). Irritation is common (occurs in about 20 ) but it is minimised by applying tazarotene sparingly to the plaques and avoiding normal skin. Narrow-band ultraviolet B (UVB) therapy offers superior efficacy with less risk of burning:NICE recommends that narrow-band UVB phototherapy should be offered to people with plaque psoriasis that cannot be controlled with topical treatments alone.