Nail psoriasis (PsO) is a disorder with profound impact on patients’ quality of life. Several challenges and unmet needs remain in the treatment of nail PsO. Introduction of biologics and small molecules in the treatment of nail PsO has allowed for rapid control of the disease and high efficacy. The aim of this review was to present the published studies on nail PsO therapy with biologics and small molecules and illuminate the results in the studies where the design and outcome evaluation had nail PsO in the forefront.

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Pazopanib induced pigmented lesions of the scrotum and the face in a patient with metastatic renal cancer Editor Pazopanib is a multi-targeted receptor tyrosine kinase inhibitor that is used for advanced/metastatic renal cell carcinoma. It blocks tumour growth by inhibiting the receptors of vascular endothelial growth factor 1-3 (VEGF 1, VEGF 2 and VEGF 3), platelet-derived growth factor a-b (PDGF a and PDGF b), fibroblast growth receptor 1 and 3 (FGF 1 and FGF 3) and c-KIT. Apoptosis, cytostasis and restriction of tumour angiogenesis are the principle effects of this inhibition. Pigmentary changes are not uncommon in patients treated by targeted anticancer agents. 1 Pazopanib has been reported to induce skin and hair hypopigmentation, but has never been associated with hyperpigmentantion. 2,3 We report a case of a 60-year-old patient, treated with pazopanib for a metastatic renal cell cancer, who developed multiple pigmented lesions of the scrotum and the face. The patient had no comorbidities and had been receiving this regimen for 1 year. The onset of lesions was observed almost 10 months after pazopanib initiation. There was no positive family history for similar lesions. Clinical examination revealed the presence of small, irregularly shaped, darkly pigmented macules of the scrotum Letters to the Editor e361