The Burden of Nail Psoriasis: An Introduction

Abstract

Nail involvement is an extremely common feature of psoriasis and affects approximately 50% of patients. Despite this, it is an often overlooked feature of the disease, and treatment tends to be focused on clearing the cutaneous component of psoriasis. Clinical manifestations of nail psoriasis are pitting, discolouration, onycholysis and subungual hyperkeratosis as well as nail plate crumbling and splinter haemorrhages. Nail psoriasis is associated with discomfort in many patients and leads to significant functional impairment and psychological stress. The often distressing appearance of affected nails impacts the patient tremendously in both work and social activities. Importantly, 80% of patients with psoriatic arthritis have nail psoriasis. This review discusses the incidence of nail psoriasis and the burden on the patient and illustrates when dermatologists are strategically placed to detect the early signs of more severe disease by promptly diagnosing and managing the nail component of psoriasis.

Psoriasis Vulgaris: An Evidence-Based Guide for Primary Care

“…52 Treating patients for more than 1 to 2 years without nephrology consultation is not recommended because of CsA-associated risk of nephrotoxicity. 17,52 Patients taking long-term therapy are also at risk of gingival hyperplasia, so yearly dental examinations are advised. 52 The current recommendations for managing nephrotoxicity are reducing the dose of CsA by 25% to 50% (equivalent to 0.5 to 1.0 mg/kg/day) if serum creatinine levels increase more than 25% to 30% above baseline on 2 occasions (repeated measurements separated by 2 weeks).…”

The microvascular and morphostructural changes of nails in psoriatic patients with nail disease; a link between ultrasound and videocapillaroscopy findings in the nailfold

“…Van Laborde et al have shown that there is an 80% to 90% lifetime incidence of nail involvement in psoriatic patients [4]. The presence of nail involvement of psoriasis is associated with an increase in patient-reported pain complaints, functional impairment and social burden, resulting in a significant restriction of daily activities and quality of life as well as resistance to treatment [5][6][7][8][9].…”

Tırnak Tutulumu Olan ve Olmayan Psoriazis Hastalarında Tırnak Yatağı ve Tırnak Plağı Kalınlığının Sonografik Olarak Değerlendirilmesi

“…%1-10 hastada ise psoriazis sadece tırnak tutulumu ile seyredebilir (3). Psoriazis hastalarının %80-90'ında hayatlarının bir bölümünde tırnak tutulumu görülmektedir (4).Psoriazis tırnak tutulumu tanısı klinik ve histopatolojik olarak konmaktadır.…”