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 - 21/06/19

Doi : 10.1016/j.jaad.2019.01.072

Dimitrios Rigopoulos, MD, PhD ^a, Robert Baran, MD, PhD ^b, Soumiya Chiheb, MD, PhD ^c, Carlton Ralph Daniel, MD, PhD ^d,^e, Nilton Di Chiacchio, MD, PhD ^f, Stamatis Gregoriou, MD, PhD ^a, Chander Grover, MD, DNB ^g, Eckart Haneke, MD, PhD ^h,ⁱ, Matilde Iorizzo, MD, PhD ^j, Marcel Pasch, MD, PhD ^k, Bianca Maria Piraccini, MD, PhD ^l, Phoebe Rich, MD ^m, Bertrand Richert, MD, PhD ⁿ, Natalia Rompoti, MD ^a,^⁎ , Adam I. Rubin, MD ^o, Archana Singal, MD, FAMS ^g, Michela Starace, MD, PhD ^l, Antonella Tosti, MD, PhD ^p, Ioanna Triantafyllopoulou, MD ^q, Martin Zaiac, MD ^r
^a University Hospital of Venereal and Skin Diseases A. Sygros, Athens, Greece
^b University of Franche-Comté, Nail Disease Center, Cannes, France
^c Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
^d University of Mississippi Medical Center, Jackson, Mississippi
^e University of Alabama, Birmingham, Alabama
^f Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
^g Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
^h Department of Dermatology, Inselspital, University Bern, Bern, Switzerland
ⁱ Centro de Dermatología, Instituto CUF, Porto, Portugal
^j Private dermatology practice, Bellinzona, Switzerland
^k Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
^l Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Bologna, Italy
^m Oregon Health and Science University, Portland, Oregon
ⁿ Saint Pierre-Brugmann and Queen Fabiola Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
^o Department of Dermatology, Hospital of the University of Pennsylvania, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
^p University of Miami Miller School of Medicine, Miami, Florida
^q Private dermatology practice, Athens, Greece
^r Greater Miami Skin and Laser Center, Department of Dermatology, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida

^∗Correspondence to: Natalia Rompoti, MD, University Hospital of Venereal and Skin Diseases A. Sygros, 5, Ionos Dragoumi, 161 21 Athens, Greece.University Hospital of Venereal and Skin Diseases A. Sygros5, Ionos DragoumiAthens161 21Greece

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.

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Key words : consensus, guidelines, intralesional steroid injection, nail psoriasis, nail psoriasis recommendation, nail psoriasis treatment

Abbreviations used : AE, IL, NAPSI, N-NAIL, NPQ10, PsA, QoL

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Materials and methods

Results

Recommendations for the treatment of nail psoriasis

Discussion

	All authors equally contributed to this report.
	Funding sources: None.
	Conflicts of interest: Dr Rigopoulos was a speaker and received honoraria from Celgene, Novartis, Janssen, and Abbvie; was a consultant and received honoraria from Celgene, Novartis, Janssen, and Abbvie; is or was a principle investigator for Abbvie and Genesis Pharma. Dr Gregoriou was a speaker and received honoraria from Abbvie, Janssen, and Novartis. Dr Pasch was an advisory board member for and received honoraria from Amgen and Celgene; was a speaker and received honoraria from Pfizer; and received research funding for fundamental research from Janssen Pharmaceutics and Pfizer. Bianca Maria Piraccini was an advisory board member for Pierre fabre-Ducray, L'Oreal, Legacy Healthcare and has received honoraria from Pierre fabre-Ducray, L'Oreal, Legacy Healthcare, Giuliani, Avangarde, Canfield, and ISDIN. Dr Rich is or was a principle investigator for Abbvie, Boehringer Ingelheim, Cell Centix, Centocor, Eli Lilly, Janssen, Kadmon, Merck, Novartis, Pfizer, and UCB. Dr Rompoti was a speaker for and received honoraria from Janssen and Novartis. Dr Tosti was a consultant for and received honoraria from P&G and Amirall and is or was a principle investigator for Incyte, Nutrifol, and Erconia Laser. Drs Baran, Chiheb, Daniel, Chiacchio, Grover, Haneke, Iorizzo, Richert, Rubin, Starace, Singal, Triantafyllopoulou, and Zaiac have no conflicts of interest to declare.
	Reprints not available from the authors.

Esportazione

Vol 81 - N° 1

P. 228-240 - luglio 2019 Ritorno al numero

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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 - 21/06/19

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