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Nail Psoriasis: a Review of Current Topical and Systemic Therapies

Caitlin Kennedy Carney, MD, Wendy Cantrell, CRNP, and Boni E Elewski, MD

Psoriasis is a chronic inflammatory skin disorder that affects approximately 2% of the US population [1,2]. Although skin involvement is the characteristic presentation of the disease, both the nails and joints may be affected as well. Nail disease is present in up to 50% of cases, and it is estimated to affect 80–90% of patients who have psoriasis at some point in their lifetime [1,3]. The prevalence of nail involvement in patients with psoriatic arthritis (PsA) is even higher at 80% [2–4]. There is a strong association between distal interphalangeal (DIP) joint disease and nail disease. The severity of nail disease has been shown to correlate with the severity of skin and joint involvement [2,5]. In 1–5% of patients with psoriasis, nail changes may occur in the absence of skin lesions and may be the only clinical sign of psoriasis [2].

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