■指甲牛皮癣(NP)在牛皮癣(PsO)患者中的患病率为10%至82%,是最常见的难以治疗的牛皮癣部位之一。我们对文献进行了彻底的回顾,探索有关所有可用的NP系统治疗的证据,还详细描述了NP专用临床试验。
在2023年2月之前在PubMed和Embase进行了文献检索,使用术语“指甲”和“牛皮癣”和“全身治疗”和/或“全身治疗”的组合。本文对47例原始研究和病例报告进行了综述。
■当疾病涉及3个以上的指甲时,应考虑全身治疗,广泛的皮肤和关节受累,并且对QoL有重大影响,由于其最佳的长期疗效。详细来说,常规和生物系统药物在最近的试验中显示出疗效,包括acitretin,甲氨蝶呤,环孢菌素,apremilast,阿达木单抗,英夫利昔单抗,依那西普,赛托珠单抗,戈利木单抗,ustekinumab,苏金单抗,ixekizumab,Brodalumab,bimekizumab,guselkumab,risankizumab和tildrakizumab.
■几种疗法已经证明了治疗NP的有效性和安全性;然而,治疗的选择不仅取决于指甲受累的严重程度,还有PsA是否存在,患者除PsA以外的合并症,既往治疗史,和病人的药物偏好。
UNASSIGNED: Nail psoriasis (NP) has a prevalence that ranges from 10 to 82% among patients with psoriasis (PsO) and is one of the most common difficult to treat site of psoriasis. We performed a thorough
review of the literature, exploring evidence regarding all available NP systemic treatments, describing also in detail NP dedicated clinical trials.
UNASSIGNED: A literature search was conducted in PubMed and Embase prior to February 2023 using a combination of the terms \"nail\" AND \"psoriasis\" AND \"systemic therapy\" AND/OR \"systemic treatment\". A total of 47 original studies and case reports were reviewed in this article.
UNASSIGNED: Systemic therapies should be considered when the disorder involves more than 3 nails, has extensive skin and joint involvement, and has a significant impact on QoL, due to their best long-term efficacy. In detail, conventional and biologic systemic drugs demonstrated efficacy in recent trials, including acitretin, methotrexate, cyclosporine, apremilast, adalimumab, infliximab, etanercept, certolizumab, golimumab, ustekinumab, secukinumab, ixekizumab, brodalumab, bimekizumab, guselkumab, risankizumab and tildrakizumab.
UNASSIGNED: Several therapies have demonstrated efficacy and safety in the treatment of NP; however, the choice of treatment depends not only on the severity of the nail involvement, but also on whether PsA is present, the patient\'s comorbidities other than PsA, previous treatment history, and the patient\'s drug preferences.