The Impact of Fingernail Psoriasis on Patients' Health-Related and Disease-Specific Quality of Life

Velden, Haike M.J. van der; Klaassen, Karlijn M.G.; Kerkhof, Peter C M van de; Pasch, Marcel C.

doi:10.1159/000360696

Cited by 23 publications

(17 citation statements)

References 20 publications

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“…Nail psoriasis has a profound negative influence on all aspects of quality of life as well as on daily, sports, and professional activities. 16 – 20 Women try to hide their nails and cover them with nail lacquer; although common nail varnishes are not harmful, artificial nails, particularly when long, increase the mechanical stress and strain to the nail plate – nail bed attachment acting as a Köbner phenomenon and worsening nail psoriasis. Similarly, professional activities with particular use of the fingers may have a deteriorating effect on the disease.…”

Section: Impact On Quality Of Lifementioning

confidence: 99%

Nail psoriasis: clinical features, pathogenesis, differential diagnoses, and management

Haneke¹

2017

PTT

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Psoriasis is the skin disease that most frequently affects the nails. Depending on the very nail structure involved, different clinical nail alterations can be observed. Irritation of the apical matrix results in psoriatic pits, mid-matrix involvement may cause leukonychia, whole matrix affection may lead to red lunulae or severe nail dystrophy, nail bed involvement may cause salmon spots, subungual hyperkeratosis, and splinter hemorrhages, and psoriasis of the distal nail bed and hyponychium causes onycholysis whereas that of the proximal nail fold causes psoriatic paronychia. The more extensive the involvement, the more severe is the nail destruction. Pustular psoriasis may be seen as yellow spots under the nail or, in case of acrodermatitis continua suppurativa, as an insidious progressive loss of the nail organ. Nail psoriasis has a severe impact on quality of life and may interfere with professional and other activities. Management includes patient counseling, avoidance of stress and strain to the nail apparatus, and different types of treatment. Topical therapy may be tried but is rarely sufficiently efficient. Perilesional injections with corticosteroids and methotrexate are often beneficial but may be painful and cannot be applied to many nails. All systemic treatments clearing widespread skin lesions usually also clear the nail lesions. Recently, biologicals were introduced into nail psoriasis treatment and found to be very effective. However, their use is restricted to severe cases due to high cost and potential systemic adverse effects.

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Section: Impact On Quality Of Lifementioning

confidence: 99%

Nail psoriasis: clinical features, pathogenesis, differential diagnoses, and management

Haneke¹

2017

PTT

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“…It is known that psoriasis on visible areas of the skin, such as the face and hands, may have a substantial negative impact on physical, psychological, and social dimensions of quality of life (QoL) [ 7 – 11 ]. In addition, fingernail psoriasis is highly visible and has a relevant and additional negative impact on the QoL of psoriasis patients, particularly in patients with both nail matrix and nail bed signs of the disease [ 12 – 14 ]. Patients with only nail bed alterations scored significant lower QoL scores when compared with patients with only nail matrix features.…”

Section: Introductionmentioning

confidence: 99%

Nail Psoriasis: A Review of Treatment Options

Pasch¹

2016

Drugs

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Nail involvement affects 80–90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. 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. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.

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“…1 Treatment can be challenging due to limited penetration through the nail plate and slow regeneration of the nail. 2 Moreover, patients with nail psoriasis are often undertreated. 3 Fortunately, scientific interest in the field of nail psoriasis has increased over the last couple of years and important new data on nail psoriasis interventions have emerged.…”

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confidence: 99%

Reporting of outcomes in randomized controlled trials on nail psoriasis: a systematic review

et al. 2018

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The Impact of Fingernail Psoriasis on Patients' Health-Related and Disease-Specific Quality of Life

Cited by 23 publications

References 20 publications

Nail psoriasis: clinical features, pathogenesis, differential diagnoses, and management

Nail psoriasis: clinical features, pathogenesis, differential diagnoses, and management

Nail Psoriasis: A Review of Treatment Options

Reporting of outcomes in randomized controlled trials on nail psoriasis: a systematic review

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