关键词: consensus guidelines intralesional steroid injection nail psoriasis nail psoriasis recommendation nail psoriasis treatment

Mesh : Acitretin / administration & dosage Administration, Oral Administration, Topical Adult Aged Biological Products / administration & dosage Consensus Cyclosporine / administration & dosage Dermatologic Agents / administration & dosage Disease Management Expert Testimony Female Humans Injections, Intralesional Male Methotrexate / administration & dosage Middle Aged Nail Diseases / diagnosis drug therapy Practice Guidelines as Topic Psoriasis / diagnosis drug therapy Recurrence Risk Assessment Severity of Illness Index Treatment Outcome

来  源:   DOI:10.1016/j.jaad.2019.01.072   PDF(Sci-hub)

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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