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Dermatol Ther 2022 Jun 22:e15660. Epub 2022 Jun 22.

Department of Dermatology Venereology and Andrology, Faculty of Medicine, Alexandria University.

Background: There is no consistently effective treatment for psoriatic nails. Topical and intralesional modalities have been recently investigated and showed promising efficacy and safety.

Objective: To compare the efficacy and safety of intralesional injection of 5-fluorouracil (5-FU), methotrexate (MTX), triamcinolone acetonide (TA) versus topical calcipotriol plus urea 20% in the treatment of nail psoriasis. Read More

Actas Dermosifiliogr 2022 May 2;113(5):481-490. Epub 2022 Feb 2.

Departamento de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.

Nail involvement in psoriasis is common. It is seen in up to 80% of patients with psoriatic lesions and may be the only manifestation in 6% of cases. Nail psoriasis is correlated with more severe disease, characterized by earlier onset and a higher risk of psoriatic arthritis. Read More

Dermatol Ther (Heidelb) 2022 Jun 11;12(6):1469-1480. Epub 2022 Jun 11.

Sapporo Skin Clinic, Sapporo, Japan.

Introduction: Patients with mild-to-moderate plaque psoriasis often experience reduced quality of life and increased disease burden due to itch or involvement of psoriasis in special areas such as the scalp and nails. Systemic therapy may be used concurrently with topical therapy in patients with active disease not controlled by topical therapy alone. The objective of PROMINENT was to evaluate the efficacy and safety of apremilast in combination with topical therapy in patients with mild-to-moderate psoriasis in Japan. Read More

FP Essent 2022 Jun;517:27-34

Department of Dermatology - University of Michigan School of Medicine, 1910 Taubman Center 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5314.

A thorough understanding of nail anatomy can help physicians identify the causes of nail conditions. Observation of changes to the nail can help establish a diagnosis. Patient evaluation should include a physical examination, dermoscopy, and, in some cases, nail biopsy. Read More

Dermatol Ther (Heidelb) 2022 Jun 7;12(6):1289-1302. Epub 2022 Jun 7.

Ortho Dermatologics (a Division of Bausch Health US, LLC), Bridgewater, NJ, USA.

Psoriatic involvement in areas of the body such as nails, palms and soles (palmoplantar), and scalp is associated with dramatically negative effects on quality of life relative to involvement elsewhere in the body. Although numerous evidence-based studies demonstrate the efficacy of biologics for overall skin clearance in moderate-to-severe plaque psoriasis (including tumor necrosis factor α [TNFα] inhibitors and interleukin [IL]-17A, IL-12/IL-23, IL-23, IL-17F, and IL-17A/F inhibitors), large, randomized, placebo-controlled clinical studies of psoriasis with nail, palmoplantar, and scalp involvement are needed to better inform decision-making in clinical practice. Moreover, biologic failure caused by drug ineffectiveness is a common occurrence in patients who do not respond, lose response, or are intolerant to treatment. Read More

J Dermatolog Treat 2022 May 29:1-8. Epub 2022 May 29.

Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Background: Guselkumab, tildrakizumab, and risankizumab, acting on interleukin(IL)23 axis, have been recently approved for psoriasis management. However, real-life data regarding their comparison are scant.

Objectives: The aim of our real life study was to perform an indirect efficacy and safety comparison among anti-IL23s, particularly focusing on difficult-to-treat areas. Read More

J Clin Med 2022 May 7;11(9). Epub 2022 May 7.

Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.

Tildrakizumab, an IL-23 inhibitor, is effective and safe for the improvement of moderate-to-severe chronic plaque psoriasis. However, little evidence is available on the use of this biologic in psoriasis in difficult-to-treat locations. In this retrospective analysis, we treated patients with 100 mg tildrakizumab at Day 0, after 4 weeks and every 12 weeks thereafter. Read More

Int J Environ Res Public Health 2022 05 5;19(9). Epub 2022 May 5.

Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-900 Olsztyn, Poland.

The assessment of psoriatic nail changes in everyday practice is based exclusively on clinical symptoms that do not reflect the entire disease process in the nail apparatus. The use of imaging methods, especially widely available and inexpensive ultrasonography, creates the possibility of additional revealing and assessing grayscale of morphological changes of the ventral nail plate, nail bed, and matrix, as well as the attachment of the finger extensor tendon to the distal phalanx. What is more, it enables the assessment of inflammation severity in the power Doppler technique. Read More

J Dtsch Dermatol Ges 2022 06 12;20(6):788-796. Epub 2022 May 12.

Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background And Objectives: The treatment of nail psoriasis is often unsatisfactory due to poor penetration of topical therapeutics through the nail plate. The development of innovative methods that provide adequate delivery of the drug into the nail is warranted. In this study, we aim to compare the efficacy of intralesional corticosteroid injection versus its topical application after fractional CO laser in the treatment of fingernail psoriasis. Read More

Int J Dermatol 2022 May 11. Epub 2022 May 11.

Weill Cornell Medicine, Department of Dermatology, New York, NY, USA.

Ned Tijdschr Geneeskd 2022 03 21;166. Epub 2022 Mar 21.

Amsterdam UMC, locatie VUmc, afd. Huisartsgeneeskunde, Amsterdam.

Background: Nail psoriasis, also called psoriasis unguium, is a variant of psoriasis in which nail changes appear due to inflammation of nail bed or nail matrix. 15% to 50% of patients with cutaneous psoriasis have nail psoriasis, the condition also occurs without or before the appearance of skin lesions.

Case Description: A 54-year-old male visits his general practitioner because of crumbling of his fingernails. Read More

Dermatol Ther 2022 Apr 14:e15513. Epub 2022 Apr 14.

Department of Microbiology, Firat University Hospital, Elazig, Turkey.

Prevalence of onychomycosis increases in patients with psoriasis and that psoriasis predisposes to onychomycosis. It was aimed to determine the frequency of onychomycosis and responsible pathogens in patients with psoriasis, to reveal their differences compared to the population without psoriasis, and to determine the factors in this study. The study included 81 patients with nail disorder diagnosed with psoriasis. Read More

Dermatol Ther (Heidelb) 2022 May 11;12(5):1121-1131. Epub 2022 Apr 11.

Derma-Köln, Cologne, Germany.

Introduction: Dimethyl fumarate (DMF) is an oral compound to treat plaque psoriasis. Data on the treatment of patients with psoriasis affecting impactful areas are scarce. In this interim analysis of the prospective, noninterventional SKILL study, we summarized results of DMF treatment regarding effectiveness (overall and in impactful areas) and safety. Read More

Exp Dermatol 2022 Jun 22;31(6):828-840. Epub 2022 Apr 22.

Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiskberg, Copenhagen, Denmark.

Background: The growing interest in the visualization of psoriatic nail unit changes has led to the discovery of an abundance of image characteristics across various modalities.

Objective: To identify techniques for non-invasive imaging of nail unit structures in psoriatic patients and review extracted image features to unify the diverse terminology.

Methods: For this systematic scoping review, we included studies available on PubMed and Embase, independently extracted image characteristics, and semantically grouped the identified features to suggest a preferred terminology for each technique. Read More

J Eur Acad Dermatol Venereol 2022 Mar 29. Epub 2022 Mar 29.

Faculty of Medicine, Department of Dermatology, Necmettin Erbakan University Meram, Konya, Turkey.

Background: Generalized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread and superficial sterile pustules on an erythematous background.

Objectives: This multicentre study aimed to determine the clinical profile and course in a large cohort of patients with GPP.

Methods: One hundred and fifty-six GPP patients (mean age, 44. Read More

Dermatol Surg 2022 May 24;48(5):539-544. Epub 2022 Mar 24.

Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background: Nail psoriasis has a major negative impact on physical and psychological aspects of the patient's life. Treatment is often unsatisfactory because of difficult penetration of the drug into the nail.

Objective: To evaluate and compare the efficacy of laser-assisted delivery of methotrexate versus its intralesional injection in fingernail psoriasis. Read More

Life (Basel) 2022 Mar 16;12(3). Epub 2022 Mar 16.

Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland.

Sarcopenia and psoriasis are different inflammatory diseases that share common comorbidities (e.g., cardiovascular diseases, metabolic syndrome, obesity, autoimmune diseases, depression). Read More

Lasers Surg Med 2022 Jul 15;54(5):688-692. Epub 2022 Mar 15.

Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.

Background And Objectives: There are limited treatment options for nail psoriasis. It is important to find new therapies and improve existing ones. The aim of this study was to compare the effectiveness of pulsed dye laser (PDL) versus combined PDL and Nd:YAG lasers in patients with nail psoriasis. Read More

Ann Med 2022 12;54(1):694-712

Department of Dermatology, Weill Cornell Medicine New York, NY, USA.

Nail conditions are not only aesthetic concerns, and nail changes may be a clue to an underlying systemic diseases or infection. Without timely treatment, nail diseases can continue to worsen and significantly impair performance of daily activities and reduce quality of life. Examination of the nails is essential at every medical visit, and may uncover important findings. Read More

Dermatol Pract Concept 2022 Feb 1;12(1):e2022010. Epub 2022 Jan 1.

Command Hospital Air Force Bangalore, India.

Background: Nail involvement in psoriasis may be assessed clinically, ultrasonologically, and dermoscopically. The aim of this study was to assess the dermoscopic features of nails in psoriasis, to compare them with the clinical findings, and to correlate them with the Nail Psoriasis Severity Index (NAPSI) score.

Methods: We recruited 120 patients with psoriatic nail changes for the study. Read More

J Fungi (Basel) 2022 Feb 3;8(2). Epub 2022 Feb 3.

2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece.

The relationship between psoriasis and onychomycosis is controversial, and the exact nature of this association remains to be clearly elucidated. In healthy nails, the compact nail plate acts as a barrier, preventing any infection. In psoriatic nails, the nail plate involvement, together with abnormalities in the blood capillaries, may lead to decreased natural defenses against microorganisms. Read More

Clin Rheumatol 2022 Jul 19;41(7):2065-2069. Epub 2022 Feb 19.

Department of Rheumatology and Immunology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.

Nail disease in psoriasis has been found to be associated with psoriatic arthritis (PsA); however, which subtype of nail disease holds greater relevance to PsA remains unclear. This study was performed to explore the associations between three subtypes of fingernail disease (pitting, onycholysis, and hyperkeratosis) and PsA among patients with psoriasis. Patients with psoriasis attending five dermatology clinics in Shanghai between January 2020 and May 2021 were examined for skin, joint, and fingernail changes. Read More

BMJ Open 2022 Feb 16;12(2):e053137. Epub 2022 Feb 16.

Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.

Purpose: Alopecia areata (AA) is a common disorder of patchy hair loss which carries a substantial psychological burden for patients. The current understanding of AA prevalence, disease course and burden is limited, and further research is needed to improve patient care. This prospective cohort of AA patients within the Danish Skin Cohort was established to provide data that can serve as a tool in future studies of for example, AA epidemiology and disease burden. Read More

Inflamm Bowel Dis 2022 Feb 4. Epub 2022 Feb 4.

Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.

Background: It is unclear whether inflammatory bowel diseases (IBDs) affect the phenotype and severity of co-occurring immune-mediated inflammatory diseases (IMIDs). We aimed to investigate the characteristics of IMIDs in relation to co-occurring IBD.

Methods: We conducted a systematic review of Medline and EMBASE databases from inception to September 2020. Read More

J Drugs Dermatol 2022 Feb;21(2):186-190

The use of various conventional systemic and topical therapies in psoriasis has resulted in various major and minor side effects. Hence, we need to switch to intralesional administration of antipsoriatic drugs, to achieve better safety and efficacy profile. Intralesional drug therapy is most suitable for scalp, nail, and localized and recalcitrant plaque psoriasis. Read More

Clin Exp Dermatol 2022 Jun 18;47(6):1165-1168. Epub 2022 Feb 18.

Dermatology Unit, IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy.

Nail disorders in general are difficult to treat and often frustrating, and this is also the case with nail psoriasis, especially when it is limited to the nails, and not affecting joints. The quality of life of patients with nail psoriasis is negatively affected, owing to the chronic course of the disease and frequent relapses. The purpose of this study was to compare treatment response and maintenance of response during follow-up of 12 patients with nail matrix psoriasis limited to a few nails, who were treated with intralesional injections of either methotrexate (MTX) 25 mg/mL or triamcinolone acetonide 10 mg/mL. Read More

Ann Acad Med Singap 2022 01;51(1):16-23

National Skin Centre, Singapore.

Introduction: Nail psoriasis treatment is challenging due to difficult drug delivery and systemic therapy toxicities. Self-dissolvable microneedle patches embedded with corticosteroids offers a potentially rapid, minimally invasive drug delivery platform with good efficacy and minimal adverse side effects.

Methods: We conducted a 4-month prospective randomised controlled trial. Read More

J Eur Acad Dermatol Venereol 2022 05 28;36(5):e389-e392. Epub 2022 Jan 28.

Rheumatology and Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP) and Fraunhofer Cluster of Excellence for Immune-Mediated Diseases, Goethe University, Frankfurt, Germany.

Exp Dermatol 2022 05 22;31(5):800-806. Epub 2022 Jan 22.

Department of Dermatology, Peking University First Hospital, Beijing, China.

Shifts in skin microbiome are considered to be involved in the pathogenesis of psoriasis. However, data on the microbial dysbiosis of nail psoriasis are scarce. In this study, we aim to investigate and characterize the nail bacterial and fungal microbiome in patients with psoriasis. Read More

Biomed Res Int 2021 13;2021:9113418. Epub 2021 Dec 13.

Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Whether nail psoriasis can increase the risk of onychomycosis is still being debated, and data relating to the prevalence of onychomycosis among psoriasis patients receiving different treatments is limited.

Objectives: To investigate the overall prevalence and prevalence compared among psoriasis treatments of onychomycosis in patients with nail psoriasis and fungal involvement.

Methods: A prospective study of three groups of nail psoriasis being treated with only topical medication, methotrexate, or biologics (25 patients per group, 150 nails) was conducted at Siriraj Hospital (Bangkok, Thailand) during November 2018 to September 2020. Read More