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2016 ; 76
(6
): 675-705
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Nail Psoriasis: A Review of Treatment Options
#MMPMID27041288
Pasch MC
Drugs
2016[Apr]; 76
(6
): 675-705
PMID27041288
show ga
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-?, 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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