Recommendations for the definition, evaluation, and treatment of nail psoriasis in adult patients with no or mild skin psoriasis: A dermatologist and nail expert group consensus

Dimitrios Rigopoulos, Robert Baran, Soumiya Chiheb, Carlton Ralph Daniel, Nilton Di Chiacchio, Stamatis Gregoriou, Chander Grover, Eckart Haneke, Matilde Iorizzo, Marcel Pasch, Bianca Maria Piraccini, Phoebe Rich, Bertrand Richert, Natalia Rompoti, Adam I. Rubin, Archana Singal, Michela Starace, Antonella Tosti, Ioanna Triantafyllopoulou, Martin Zaiac

Research output: Contribution to journalReview article

7 Scopus citations

Abstract

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 formal consensus methods. During this process, the panel strived to establish an agreement regarding the definition of nail psoriasis, the severity of nail psoriasis, and treatment response. Treatment recommendations are provided regarding nail psoriasis severity and matrix or bed involvement. Few-nail disease was considered as nail psoriasis affecting ≤3 nails. In the case of matrix involvement only, intralesional steroid injections were considered the treatment of choice. Topical steroids alone or in combination with topical vitamin D analogues were suggested for nail psoriasis limited to the nail bed. For the systemic treatment of nail psoriasis acitretin, methotrexate, cyclosporine, small molecules, and biologics may be employed.

Original languageEnglish (US)
Pages (from-to)228-240
Number of pages13
JournalJournal of the American Academy of Dermatology
Volume81
Issue number1
DOIs
StatePublished - Jul 2019

Keywords

  • consensus
  • guidelines
  • intralesional steroid injection
  • nail psoriasis
  • nail psoriasis recommendation
  • nail psoriasis treatment

ASJC Scopus subject areas

  • Dermatology

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    Rigopoulos, D., Baran, R., Chiheb, S., Daniel, C. R., Di Chiacchio, N., Gregoriou, S., Grover, C., Haneke, E., Iorizzo, M., Pasch, M., Piraccini, B. M., Rich, P., Richert, B., Rompoti, N., Rubin, A. I., Singal, A., Starace, M., Tosti, A., Triantafyllopoulou, I., & Zaiac, M. (2019). Recommendations for the definition, evaluation, and treatment of nail psoriasis in adult patients with no or mild skin psoriasis: A dermatologist and nail expert group consensus. Journal of the American Academy of Dermatology, 81(1), 228-240. https://doi.org/10.1016/j.jaad.2019.01.072