We have also discussed the available treatment options, including the topical, physical, systemic, and biological modalities, in great detail in order to equip the present day dermatologist in dealing with a big clinical challenge, that is, management of nail psoriasis. However, keeping in mind its efficacy in the treatment of skin psoriasis, it can prove to be a very useful tool in the treatment of nail psoriasis. 2013;169:3149. Psoriasis is a common, chronic, relapsing, inflammatory skin disorder with a strong genetic basis. See separate Psoriatic Nail Disease article. Tools such as the Psoriasis Area and Severity Index (PASI) may be used to express disease severity, based on severity of lesions and extent of skin involvement. This paper reviews the currently available tools for the clinical measurement of the disease activity in PsA. Discussions at GRAPPA and OMERACT meetings recommended that the ACR joint count of 68 tender and 66 swollen joints count be used, as it includes a majority of joints affected in PsA, and it can be readily performed in a clinic visit 4. PsA disease activity is commonly not mirrored by active skin disease. Psoriatic nail disease can be broadly divided into psoriasis affecting the nail matrix and the nail bed. 162169, 2004.
Sixteen PsA patients receiving anti-TNF- therapy were enrolled. There is an increasing body of evidence supporting power Doppler (PD) US as a sensitive imaging technique for the assessment of disease activity and therapy monitoring in patients with chronic arthritis, including PsA 11 16. Psoriatic skin and nail lesions were assessed by PDUS as follows: representative US images were acquired at both the centre and the margins of the psoriatic plaque lesion and the surrounding normal skin. Discussion. Taking into account the information listed above, we tested the possibility of using PDUS as a tool that is able to measure globally the inflammatory process by detecting perfusion changes induced by TNF- antagonist. Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disorder associated with a heterogeneous disease presentation, varied disease expression and an unpredictable but often chronically destructive clinical course. 3, 169177 (2003). Treatment options for moderate to severe psoriasis include topical and systemic medications, phototherapy, and excimer laser. The nail bed often separates from the skin of the finger and collections of dead skin can build up underneath the nail. Physicians may also use several assessment tools to evaluate severity. Regular monitoring for liver toxicity includes blood tests and sometimes liver biopsies. 2013;169(4):783-93.
This is helpful in treating psoriasis, which causes skin cells to grow too rapidly. There are two types of ultraviolet (UV) light therapy: ultraviolet B (UVB) and ultraviolet A (UVA). Tools & Resources. Your dermatologist will monitor your overall exposure to UV rays. Skin damage. 169-193. New York: McGraw-Hill Medical. Habif TP, et al. (2011). Before treatment for psoriasis can be initiated, the grading and severity must be determined (Table 4). There has been no evidence of skin atrophy or absorption by the body. In the case of nail psoriasis, injecting the proximal nail fold to target the proximal nail matrix reduces nail inflammation. Risks versus benefits should be discussed because of possible adverse effects; continuous monitoring is required with this drug. Overview Psoriasis is a noncontagious, lifelong skin condition that affects.
Development Of A Preliminary Us Power Doppler Composite Score For Monitoring Treatment In Psa
The Simplified Psoriasis Index (SPI) is a summary measure of psoriasis with separate components for current severity (SPI-s), psychosocial impact (SPI-p), and past history and interventions (SPI-i). The presence of significant nail disease can be captured in the extent scores for hands and feet (Figure 1). 72 (132/184) of all patients referred to the unit had some sort of skin-nail psoriasis. Discussion. Original Article from The New England Journal of Medicine Etanercept as Monotherapy in Patients with Psoriasis.