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J Dermatol 2019 Apr 15. Epub 2019 Apr 15.

AbbVie GK, Tokyo, Japan.

Psoriasis is a chronic autoimmune disease affecting skin which may also manifest in nails and joints. Several biologic treatments have been approved in Japan for psoriasis. Each biologic has a different profile for efficacy and safety, including different dosing regimens and co-payment considerations which may complicate treatment decisions made by patients and physicians during short consultations. Read More

Dermatol Ther 2019 Apr 9:e12914. Epub 2019 Apr 9.

Dermatology Unit, University of Rome "Tor Vergata", Rome, Italy.

Nail involvement can place a significant burden on patients as a result of functional damage and psychosocial problems, leading to major repercussions on the quality of life. There is strong evidence that nail psoriasis can often be difficult to treat. We report a a 69 year-old-man with severe onychodystrophy, onycholysis, and pain in the hands; he had been previously treated with topical and systemic traditional therapies without satisfactory response. Read More

J Cutan Med Surg 2019 Mar 27:1203475419839937. Epub 2019 Mar 27.

1 Cutaneous Lymphoma Program, Department of Dermatology, University of Pittsburgh Medical Center, PA, USA.

Background:: The onychodystrophies associated with Sézary syndrome (SzS) have rarely been described in the literature. We performed a retrospective analysis of SzS patients at a single institution and compared our data with previous publications.

Objectives:: The objectives of this study were to identify and describe the most frequent nail alterations in patients with SzS. Read More

Dermatol Clin 2019 Apr 14;37(2):143-147. Epub 2019 Feb 14.

Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 Northwest 10th Avenue #1140, Miami, FL 33136, USA.

Various advancements in the diagnosis and management of nail diseases have transpired in recent years. To provide the best care for patients with nail complaints, it is essential that physicians be updated on new diagnostic and treatment modalities. The purpose of this article is to discuss new and oncoming diagnostic and management options for nail disorders, including nail psoriasis, retronychia, brittle nails, onychotillomania, trauma, trachyonychia, and pyogenic granulomas. Read More

Sci Rep 2019 Mar 6;9(1):3628. Epub 2019 Mar 6.

Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-900, Olsztyn, Poland.

The aim of the study was an ultrasound assessment of distal interphalangeal (DIP) joint enthesopathy in patients with nail psoriasis. Altogether, 72 patients with nail psoriasis (41 with psoriasis and 31 with psoriatic arthritis) and 30 people in the control group participated in the study. In total, 1014 nails were examined. Read More

Pediatr Dermatol 2019 Mar 11;36(2):189-192. Epub 2019 Feb 11.

Department of Pathology, Dr. Behcet Uz Children's Research and Training Hospital, Izmir, Turkey.

Objective: Lichen nitidus (LN) is an uncommon inflammatory skin eruption. The present study aims to describe a case series of children with LN seen at a tertiary-care health center.

Methods: Retrospective study of 17 children with biopsy-proven LN between January 2007 and March 2017. Read More

J Am Acad Dermatol 2019 Feb 4. Epub 2019 Feb 4.

Greater Miami Skin and Laser Center, Department of Dermatology, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.

Nail involvement in psoriasis is common, and the severity of it does not always parallel the intensity of cutaneous disease. We created a consensus group, of which the aim was to provide practical recommendations for the treatment of nail psoriasis in patients without skin psoriasis, or with mild skin lesions with no indication for a systemic treatment. This collaborative process was conducted by an international panel of dermatologists with special expertise in nail disorders, using a formal consensus methodology. Read More

Br J Dermatol 2019 Jan 24. Epub 2019 Jan 24.

Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.

Background: Traditionally, psoriasis in certain body sites such as the scalp, nails, palms, soles, and the intertriginous areas has been acknowledged as difficult-to-treat.

Objective: To investigate the body location of treatment-resistant psoriasis in patients treated with biologic agents in real-world clinical practice, and to study the association between localisation and the quality of life.

Methods: In this observational study we investigated the skin and/or nail location of treatment-resistant psoriasis in patients with moderate-to-severe psoriasis treated for > 6 months with biologic agents with a partial or good response to treatment defined as having a PASI ≥ 1 and ≤ 5. Read More

Reumatologia 2018 23;56(6):392-398. Epub 2018 Dec 23.

Department of Dermatology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland.

Psoriasis is a chronic inflammatory dermatosis affecting 1-3% of the general population. Patients with psoriasis represent a heterogeneous population with individual disease expression - different degrees and severity of skin involvement. Psoriatic lesions in particular localizations such as the face, scalp, intertriginous or palmoplantar areas significantly reduce quality of life. Read More

Clin Rheumatol 2019 Mar 15;38(3):913-920. Epub 2019 Jan 15.

Rheumatology Unit, Department of Medicine, University of Verona, Piazzale A. L. Scuro 1, 37138, Verona, Italy.

Introduction And Objectives: The nail unit is a subject of interest in several diseases, often involving different medical fields. Even if few data are available for psoriasis and psoriatic arthritis, no data regarding ultrasonography and imaging are present for other degenerative and inflammatory conditions. The aim of this study was to explore through imaging the changes of nail and enthesis in inflammatory and degenerative conditions in order to find qualitative and quantitative changes related to distal interphalangeal joints. Read More

Int J Dermatol 2019 Jan 7. Epub 2019 Jan 7.

Dermatology Department, Abbassi Shaheed Hospital, Karachi, Pakistan.

Background: Treatment of psoriatic nail disease is challenging, and dystrophic psoriatic nails can get secondarily infected with fungi.

Methods: This 2-year, matched case-control study was conducted at three tertiary care centers of Karachi, Pakistan. Data were collected from patients with nail psoriasis as cases with age- and gender-matched controls. Read More

Dermatol Res Pract 2018 21;2018:2637691. Epub 2018 Nov 21.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Background And Objective: Psoriasis is a common chronic inflammatory skin disorder affecting any age and gender. The clinical presentation of the nail disease depends on the location of the pathology: nail bed or nail matrix. We aimed to compare the therapeutic effects of triamcinolone acetonide iontophoresis (TI) and topical calcipotriol/betamethasone dipropionate in the nail bed and nail matrix involvements of psoriasis using Nail Psoriasis Severity Index (NAPSI). Read More

J Clin Med 2018 Dec 14;7(12). Epub 2018 Dec 14.

Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-900 Olsztyn, Poland.

To assess the effect of methotrexate on the development of distal interphalangeal joint extensor tendon enthesopathy in psoriasis, thirty-two people aged 34 to 57 years with nail psoriasis and distal interphalangeal joint extensor tendon enthesopathy (19 patients with Ps (psoriasis) and 13 with PsA (psoriatic arthritis) were started on methotrexate at 15 to 25 mg/week and the treatment was continued for 6 months). A total of 319 nails were examined. After six months of treatment, the thicknesses of the nail plate, nail bed and nail matrix were found to decrease in both groups of patients. Read More

Pharmaceutics 2018 Dec 13;10(4). Epub 2018 Dec 13.

Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Santiago de Compostela 15782, Spain.

Nail delivery has interest for local treatment of nail diseases. Nevertheless, the low permeability of drugs in the nail plaque precludes the efficacy of local treatments. The use of penetration enhancers can increase drug permeability and improve the efficacy of the treatment of nail pathologies. Read More

Rheumatol Int 2019 Apr 10;39(4):697-705. Epub 2018 Dec 10.

Department of Social Psychology and Methodology, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain.

To assess the discriminative utility of nail features detected by B-mode (BM) and color Doppler (CD) ultrasound (US) between patients with psoriasis (PsO) and psoriatic arthritis (PsA) and healthy controls. Sixty patients with PsA, 21 patients with PsO, and 20 healthy controls were prospectively included. All patients underwent a dermatologic assessment and PsA patients also a rheumatologic assessment. Read More

Acta Derm Venereol 2018 12 6. Epub 2018 Dec 6.

Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 1, IT-40138 Bologna, Italy.

Nail psoriasis affects 50-79% of patients with skin psoriasis and up to 80% of patients with psoriatic arthritis, and can also represent a negative prognostic factor in individuals with plaque psoriasis. Treatments for nail psoriasis are limited, as nails are often difficult to treat with topical therapies alone, and relapse is common. Among different systemic agents, secukinumab, a fully human monoclonal antibody targeting interleukin (IL)-17A, is the only antibody supported by a trial specifically conducted in patients with nail psoriasis (the TRANSFIGURE trial) and has the longest follow-up available to date. Read More

N Engl J Med 2018 Nov;379(22):e39

Universitat Internacional de Catalunya, Barcelona, Spain.

Dermatol Pract Concept 2018 Oct 31;8(4):283-291. Epub 2018 Oct 31.

Postgraduate Department of Dermatology, STD & Leprosy, Government Medical College, Srinagar, University of Kashmir, Jammu & Kashmir, India.

Background: Nail disorders comprise approximately 10% of all dermatological conditions. Because diagnosis is not always possible by clinical means alone, additional diagnostic procedures may be required at times. Dermoscopy of nails (onychoscopy) has shown promising results in diagnosing various nail disorders and also avoids time-consuming investigations such as culture and biopsy. Read More

Br J Dermatol 2018 Nov 14. Epub 2018 Nov 14.

Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Background: Different phenotypes have been described in psoriasis. Few details are known about the topology of patients in routine care.

Objectives: To characterize the frequency and distribution of body sites affected by psoriasis in Germany. Read More

J Eur Acad Dermatol Venereol 2019 Apr;33(4):648-660

Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.

Dermoscopy is a non-invasive in-office method, which enables the diagnosis of many dermatoses and reduces the need for performing biopsies. To date, no systematic review about the diagnostic usability of dermoscopy in psoriasis has been available. The objective of this article was to summarize and critically analyse literature data on the dermoscopy of skin, scalp and nail changes in psoriasis. Read More

Eur J Dermatol 2018 Oct;28(5):575-596

Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.

Clinical diagnosis of inflammatory skin disorders (ISD), including hair and nail disorders, is not always straightforward. Not uncommonly, a punch biopsy may be required. Dermoscopy and videodermoscopy (VD) are non-invasive techniques that are used for in vivo examination of the skin, hair, and nails. Read More

Biomed Res Int 2018 9;2018:8251097. Epub 2018 Sep 9.

Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-900 Olsztyn, Poland.

Aim Of The Study: The aim of the study was to conduct an ultrasound (US) assessment of changes in fingernails in psoriatic patients with nail involvement.

Material: A total of 69 patients with psoriatic changes in nails participated in the study, including 38 patients with psoriasis (Ps) and 31 with psoriatic arthritis (PsA) and 30 people in the control group. A total of 988 nails were examined. Read More

Indian Dermatol Online J 2018 Sep-Oct;9(5):314-317

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

Background: Nail involvement in psoriasis is often complicated by concomitant fungal infections. The aim of this study was to investigate the prevalence of fungal infections in nail psoriasis and correlate it with the severity of nail psoriasis.

Materials And Methods: This retrospective study included patients with nail psoriasis aged ≥18 years with at least one fingernail and one toenail involvement who were treated at Siriraj Hospital from September 2012 to January 2014. Read More

Dermatol Ther (Heidelb) 2018 Dec 25;8(4):647-651. Epub 2018 Sep 25.

Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia.

Psoriasis is a chronic inflammatory disease affecting the skin, nails, and joints. About 61% of psoriatic patients have nail involvement that can cause a significant social problem. Treating nail psoriasis is challenging but can improve the health outcomes and quality of life of patients. Read More

Rheumatol Int 2018 Nov 17;38(11):2087-2093. Epub 2018 Sep 17.

Department of Rheumatology, Institute of Post Graduate Medical Education and Research, Doctor's hostel. 242 A J C Bose Road, Kolkata, West Bengal, 700020, India.

Ultrasound (USG) of nail was performed to assess, (1) morphological alterations of nail plates in psoriatic arthritis (PsA) patients, (2) differences of nail unit parameters [nail bed thickness (NBT), nail matrix thickness (NMT) and nail plate distance (NPD)] in PsA patients from healthy controls (3) correlation of nail unit parameters with PsA disease activity indices. Total of 895 fingernails (448 nails of 45 PsA patients and 447 of 45 controls) were evaluated by USG. Psoriasis Area and Severity Index (PASI), Disease Activity in Psoriatic Arthritis (DAPSA), and Nail Psoriasis Severity Index (NAPSI) were calculated in PsA patients. Read More

Cureus 2018 Jul 5;10(7):e2929. Epub 2018 Jul 5.

Dermatologist, San Diego Family Dermatology, San Diego, USA.

A sign is a physical feature or microscopic change which can be observed when the patient or their tissue specimen is evaluated. An astute clinician or pathologist may be able to diagnose a patient's condition by recognizing this unique morphologic feature or pathological change. In dermatology, the flag sign-alternating transverse bands of the skin or its adnexal structures that are analogous to the alternating colors of the stripes of a flag-has been associated with distinctive disorders of the hair, skin, or nails. Read More

Clin Rheumatol 2018 Oct 29;37(10):2741-2749. Epub 2018 Jul 29.

Clinica Medica, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Via Tronto 10/A, 60126, Ancona, Italy.

Psoriatic arthritis (PsA) is a chronic inflammatory autoimmune arthritis, occurring in patients with psoriasis (Pso), that may affect the whole musculoskeletal system but also nails, eye, and gastrointestinal tract. Dermatologists and rheumatologists usually manage Pso and PsA separately, but early diagnosis and integrated management could achieve better outcomes of both skin and musculoskeletal manifestations, thus improving the health-related quality of life (HRQoL) of patients. In this work, we have described a model of integrated dermo-rheumatologic approach for the early diagnosis of PsA and to present the outcomes of the multidisciplinary management of PsA patients after 48 weeks of follow-up. Read More

Dis Mon 2019 Mar 20;65(3):51-90. Epub 2018 Jul 20.

University of Chicago Pritzker School of Medicine, Chicago, IL, United States; NorthShore University HealthSystem, Department of Medicine, Division of Dermatology, 9933 Woods Drive, Skokie, IL, United States.

Psoriasis is a chronic inflammatory disease that affects approximately 7.5 million people in the United States. The disease results in significant suffering, morbidity, and economic impact. Read More

Postepy Dermatol Alergol 2018 Jun 24;35(3):309-313. Epub 2018 Apr 24.

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

Introduction: The role of a number of inherited, acquired and environmental factors has been identified to increase the risk of onychomycosis. The literature data on psoriasis as a risk factor are contradictory. The potential relationship between these pathologies is very important as it influences the patient management. Read More

Med Monatsschr Pharm 2017 Jun;40(6):234-7

Psoriatic disorders are a visual diagnosis. Aside from several subtypes of skin psoriasis, skin appendages such nails are often affected. The burden of disease is defined by the disease activity (extent of affliction of skin) as well as restriction of quality of life. Read More

Maedica (Buchar) 2018 Mar;13(1):25-33

"Carol Davila" University of Medicine and Pharmacy, Division of Dermato-Venereology, Bucharest, Romania.

Background: Psoriasis vulgaris is a chronic inflammatory hyper-proliferative disease of the skin, scalp, nails, and joints. It has been hypothesized that prolactin (PRL) may modulate the skin immune system and be involved in the pathogenesis of psoriasis. Psoriasis exerts significant, negative impact on patients' quality of life. Read More

JAMA Dermatol 2018 Jun;154(6):676-683

Oregon Medical Research Center, Portland.

Importance: Psoriasis of the scalp, palms and/or soles, and nails is challenging to treat.

Objective: To evaluate the effect of guselkumab on psoriasis in specific body regions.

Design, Setting, And Participants: VOYAGE 1 and VOYAGE 2 were, double-blind, placebo- and adalimumab-controlled studies of guselkumab conducted at 101 and 115 global sites, respectively, from November 3, 2014, to May 19, 2016. Read More

J Dermatolog Treat 2019 Mar 29;30(2):117-122. Epub 2018 May 29.

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

Background: Even though the traditional therapy for nail psoriasis has been used for decades, no randomized, controlled trial of such treatment has been conducted to date.

Objective: To evaluate the efficacy and safety of intralesional triamcinolone injections compared with 0.05% clobetasol ointment for psoriatic nails. Read More

Breast Cancer Res Treat 2018 Aug 7;171(1):103-110. Epub 2018 May 7.

Bedford and Addenbrooke's Cambridge University Hospital Trusts c/o The Primrose Unit, Kempston Rd, Bedford, MK42 9DJ, UK.

Purpose: Nail damage is common amongst patients receiving chemotherapy causing disfigurement and pain. This investigation evaluated whether a topical balm containing steam-extracted, bioactive polyphenolic-rich herbal oils blended with organic waxes could protect the nails via their reported anti-inflammatory, analgesic, anti-oxidant and anti-microbial properties.

Methods: 60 patients (23M, 37F) were randomised to apply (2-3/day) either the plant balm (PB) or a petroleum control (PC) to their nail beds. Read More

Med Ultrason 2018 May;20(2):185-191

Department of Dermatology, Sakarya Education and Research Hospital, Sakarya, Turkey.

Objective: The objective of this study is to evaluate the link between nail fold vessel resistive index (NVRI) measured by ultrasound (US) and capillary loops diameters measured using nailfold videocapillarascopy (NVC), and to assess the morphological appearance of the nail bed in patients with psoriatic nail disease (PND) as compared with healthy controls (HCs).

Material And Methods: This study was conducted in patients with PND and HCs. General demographic data were collected and clinical assessments were performed for all subjects. Read More

Med Ultrason 2018 May;20(2):177-184

Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy.

Aims: The nail unit is a matter of interest both for dermatologist and rheumatologist. The nail is considered one of the possible targets of assessment, especially when ultrasonography is performed. The aim of the study is to highlight peculiar features and alterations of the nail unit in patients affected by psoriasis and psoriatic arthritis versus healthy controls using ultrasonography. Read More

J Eur Acad Dermatol Venereol 2018 Oct 24;32(10):1728-1736. Epub 2018 May 24.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Background: Nail psoriasis disease is associated with an increased probability of psoriatic arthritis, and its clinical signs may have different correlates with the pathogenesis of adjacent bone destruction and have different prognostic value. Recent publications about psoriasis and nail psoriatic disease describe different ultrasonographic findings but the relationship between these ungueal alterations measured by ultrasonography and the presence of enthesopathy of the extensor digitorum has yet to be discovered.

Objective: To describe which ultrasonographic characteristics of nail psoriasis are associated with the presence of subclinical enthesopathy in patients with PsO and asymptomatic PsA. Read More

Eur J Pharm Biopharm 2018 Jul 17;128:48-56. Epub 2018 Apr 17.

Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Spain; Industrial Pharmacy Institute, University of Santiago de Compostela, Spain.

Despite the important nail alterations caused by onychomycosis and psoriasis few studies have characterized the microstructure of the diseased nail plate and the diffusion and penetration of drugs through this altered structure. This work aimed to characterize the microstructure of the healthy, onychomycotic and psoriatic human nail using Raman spectroscopy, scanning electron microscopy, optical microscope profilometry and mercury intrusion porosimetry followed by analysis of the structure with PoreCor® software. The results showed that onychomycotic nails have higher porosity and lower amounts of disulphide bonds compared to healthy nails. Read More

Expert Opin Pharmacother 2018 04 22;19(6):561-575. Epub 2018 Mar 22.

a Division of Dermatology , Baylor Scott and White , Dallas , TX , USA.

Introduction: Despite great therapeutic advancements in psoriasis, four notable difficult-to-treat areas including the scalp, nails, intertriginous (including genitals), and palmoplantar regions, pose a challenge to both physicians and patients. Localized disease of these specific body regions inflicts a significant burden on patients' quality of life and requires an adequate selection of treatments.

Areas Covered: This manuscript discusses appropriate therapies and important treatment considerations for these difficult-to-treat areas based on the available clinical data from the literature. Read More

Indian J Dermatol Venereol Leprol 2018 Jul-Aug;84(4):419-423

Department of Dermatology, Venereology and Leprology, Guru Gobind Singh Medical College, Faridkot, Punjab, India.

Background: One of the most effective options available for treating psoriatic fingernails is intramatricial injection of triamcinolone acetonide. Efficacies of intramatricial methotrexate and cyclosporine have not been comparatively evaluated to date.

Methods: Ninety fingernails in 17 patients were assigned to three groups of thirty nails each, and treated with intramatricial injections of triamcinolone acetonide (10 mg/ml), methotrexate (25 mg/ml) and cyclosporine (50 mg/ml) respectively. Read More

Sci Rep 2018 Mar 7;8(1):4124. Epub 2018 Mar 7.

Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, 77843, USA.

Psoriasis is a chronic inflammatory disease that affects the skin, nails, and joints. For understanding the mechanism of psoriasis, though, alternative splicing analysis has received relatively little attention in the field. Here, we developed and applied several computational analysis methods to study psoriasis. Read More

Dermatol Ther 2018 05 6;31(3):e12589. Epub 2018 Mar 6.

Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio.

Psoriasis of the scalp, face, intertriginous areas, genitals, hands, feet, and nails is often underdiagnosed, and disease management can be challenging. Despite the small surface area commonly affected by psoriasis in these locations, patients have disproportionate levels of physical impairment and emotional distress. Limitations in current disease severity indices do not fully capture the impact of disease on a patient's quality of life, and, combined with limitations in current therapies, many patients do not receive proper or adequate care. Read More

Eur J Pharm Sci 2018 May 6;117:270-278. Epub 2018 Mar 6.

Department of Pharmacology, Pharmacy and Pharmaceutical Technology, University of Santiago de Compostela, Spain; Industrial Pharmacy Institute, University of Santiago de Compostela, Spain. Electronic address:

Soluble derivatives of β-cyclodextrin (CD) have a high capacity to solubilise hydrophobic molecules and to interact with proteins and membrane component. As consequence CD derivatives shows a significant activity as drug absorption enhancers through different delivery routes, such as the oral, nasal, ocular or topical route. In this paper, the effect of two CD derivatives -methyl-β-cyclodextrin (MBCD) and hydroxypropyl-β-cyclodextrin (HPB)- on the structure and permeability of the nail plate has been studied using the drug model ciclopirox olamine. Read More

Clin Exp Dermatol 2018 Jul 16;43(5):606-607. Epub 2018 Feb 16.

Department of Dermatology, Fundació Privada Hospital Asil de Granollers, Avinguda Francesc Ribas s/n, 08402, Granollers, Spain.

Psoriasis (Auckl) 2017 16;7:51-63. Epub 2017 Oct 16.

Department of Dermatology, Inselspital, University of Bern, Bern, Switzerland.

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. Read More

Calcif Tissue Int 2018 05 12;102(5):559-574. Epub 2018 Jan 12.

Allergy, Immunology & Rheumatology Division, University of Rochester Medical Center, Rochester, NY, 14623, USA.

Psoriatic arthritis (PsA) is an inflammatory rheumatic disorder that occurs in patients with psoriasis and predominantly affects musculoskeletal structures, skin, and nails. The etiology of PsA is not well understood but evidence supports an interplay of genetic, immunologic, and environmental factors which promote pathological bone remodeling and joint damage in PsA. Localized and systemic bone loss due to increased activity of osteoclasts is well established in PsA based on animal models and translational studies. Read More

Pediatr Dermatol 2018 Mar 4;35(2):202-207. Epub 2018 Jan 4.

Division of Pathology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brasil.

Background/objectives: Nail clipping, the act of cutting the distal portion of a nail for microscopic analysis, can complement the diagnosis of skin diseases with nail involvement, such as psoriasis. This study aimed to describe histopathologic findings on 81 nails from 52 children and adolescents with skin psoriasis and to determine whether these changes correlated with the severity of skin and nail involvement.

Methods: Children with psoriasis were enrolled in this cross-sectional study to obtain Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores. Read More

Clin Exp Dermatol 2018 Jun 21;43(4):460-461. Epub 2017 Dec 21.

Department of Dermatology, Fukushima Medical University, 1 Hikariga oka, Fukushima City, Fukushima, 960-1295, Japan.

J Eur Acad Dermatol Venereol 2018 Mar 29;32(3):397-402. Epub 2018 Jan 29.

Cardiff University and University Hospital of Wales, Wales, UK.

Background: Apremilast, an oral phosphodiesterase-4 inhibitor, has demonstrated efficacy in patients with moderate to severe psoriasis.

Objective: To evaluate long-term efficacy and safety of apremilast in biologic-naive patients with moderate to severe plaque psoriasis and safety of switching from etanercept to apremilast in the phase 3b LIBERATE trial.

Methods: Two hundred fifty patients were randomized to placebo, apremilast 30 mg BID or etanercept 50 mg QW through Week 16; thereafter, all patients continued or switched to apremilast through Week 104 (extension phase). Read More

Expert Rev Clin Immunol 2018 01 9;14(1):21-28. Epub 2017 Dec 9.

a Leeds Institute of Rheumatic and Musculoskeletal Medicine , University of Leeds, Chapel Allerton Hospital , Leeds , UK.

Introduction: Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory arthritis characterised by a range of musculoskeletal conditions including enthesitis, dactylitis and synovitis as well as skin and nail manifestations. The foot is a complex mixture of tissues, all of which can be involved in this disease and is frequently the presenting feature. Areas covered: In this under-researched area, articles were reviewed from the authors' publications as well as from other known authors. Read More