Novel approaches to psoriatic onychopathy diagnostics and treatment

Abstract

Psoriasis is one of the most important problems in the clinical practice of a dermatovenereologist. In addition to damage of the skin and joints, the nail involvement is often seen in psoriatic patients. Despite its wide prevalence and significant impact on the quality of life, psoriatic onychopathy is discussed relatively rare. A change in the nails may indicate early alterations in the small joints of the palms, еthat foster to suspect psoriatic arthritis at an earlier time. Besides, the severity of nails lesions determined on the base of the NAPSI index correlates directly with the severity of pain in enthesitis. Nails damage in psoriasis does not entail persistent functional disorders, but significantly affects the patient’s quality of life due to a visible cosmetic defect. In addition, psoriatic onychopathy is difficult to treat. The use of topical agents is impractical, and systemic therapy gives a weak clinical response over a longer period. Even in the absence of a pathological process on the skin, nail psoriasis may persist much longer, which causes significant discomfort to patients. The study of pathomorphological aspects and mechanisms of nail psoriasis development will allow to disover a new methods for the effective treatment of psoriatic onychopathy.