Psoriatic Nail Disease: How Should It Be Handled?

The recommendations of this consensus statement represent a logical and reasonable approach to this vexing problem.

Evidence regarding appropriate management of psoriasis-associated nail disease is lacking, despite considerable associated pain and negative quality-of-life effects. The Medical Board of the National Psoriasis Foundation issued a consensus statement on management based on expert opinion and review of all relevant articles cited in PubMed from 1947 through May 2014.

Nail pitting, the most common manifestation, is caused by matrix involvement, which can also cause leukonychia and nail dystrophy. Nail bed psoriasis presents as onycholysis, oil drop patches, subungual hyperkeratosis, and splinter hemorrhages. Nail disease may indicate psoriatic arthritis; up to 70% of patients with joint involvement have nail disease. Patients with abnormalities…

Reviewing Author

Craig A. Elmets, MD

Disclosures

Consultant / Advisory board Astellas Pharmaceuticals

EquityVaxin

Grant / Research support NIH; NIH/NCI; Veteran’s Administration; Ferndale Laboratories; Kyowa Hakko Kirin Pharma, Inc.

Editorial boards Cancer Prevention Research; Photodermatology, Photoimmunology, & Photomedicine; UpToDate; eMedicine; Journal of Dermatological Sciences; JAMA Dermatology

Leadership positions in professional societies American Academy of Dermatology (Vice Chair, Committee on Science and Research); Photomedicine Society (Board of Directors)