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

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