Document Detail

Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy.
MedLine Citation:
PMID:  17572277     Owner:  NLM     Status:  MEDLINE    
Psoriasis is a chronic skin disease that affects millions of people throughout the world. Even though cutaneous signs and symptoms are the most common clinical manifestations, the nails can be involved in up to 50% of cases, and their involvement remains an important yet often overlooked aspect of the disease. There is a broad spectrum of nail dystrophies associated with psoriasis, ranging from the common pitting and loosening of the nail plate to the less frequent discoloration and splinter hemorrhages seen in the nail bed. This article discusses the normal anatomy and embryology of the nail unit as well as the current understanding of the pathogenesis of the disease. It also provides an extensive review of the existing literature with respect to psoriatic nail therapy. Although there have been many recent advances in the treatment of the cutaneous form of the disease-most notably in the field of immunotherapies-the options for nail psoriasis are far more limited. While a number of treatment alternatives currently exist for nail disease, the general paucity of clear evidence regarding these choices often makes it difficult to select the most efficient, safe, and optimal treatment for the patient. Even though the current literature has shown some support for the use of topical, intralesional, radiation, systemic, and combination therapies for nail psoriasis, the available studies lack sufficient power to extrapolate a standardized therapeutic regimen. Therefore, until better-documented evidence validating the treatment options emerges within the literature, clinicians and patients are left with a vague and relatively unproven approach to psoriatic nail disease.
Michael M Jiaravuthisan; Denis Sasseville; Ronald B Vender; Francis Murphy; Channy Y Muhn
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  57     ISSN:  1097-6787     ISO Abbreviation:  J. Am. Acad. Dermatol.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-18     Completed Date:  2007-06-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-27     Citation Subset:  IM    
Department of Dermatology, University of Toronto, Canada.
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MeSH Terms
Administration, Topical
Adrenal Cortex Hormones / administration & dosage
Anthralin / therapeutic use
Clinical Trials as Topic
Cyclosporine / therapeutic use
Fluorouracil / therapeutic use
Injections, Intralesional
Nail Diseases* / diagnosis,  pathology,  radiotherapy,  therapy
Nails / anatomy & histology*,  embryology,  physiology
Nicotinic Acids / therapeutic use
Psoriasis* / diagnosis,  immunology,  pathology,  radiotherapy,  therapy
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Nicotinic Acids; 118292-40-3/tazarotene; 480-22-8/Anthralin; 51-21-8/Fluorouracil; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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