Psoriasis and psoriatic

nails

Jessica Peter Roscoe

A little about Psoriasis...

Be familiar with the different clinical presentations

of psoriasis

List the systemic complications

of severe psoriasis

> Psoriatic arthritis

> Uveitis

> Risk of CKD

List at least five possible

aggravating factors for psoriasis

> Chronic infections

> Stress

> Scratching

> Excessive alcohol

> Obesity

> Climate changes

Know the various topical treatment

options for psoriasis

Emollients

Vitamin D analogues

(calcipotriol)

Keratolytics

Coal tar

Dithranol

Topical corticosteroids

(eumovate)

Why don’t we use systemic steroids?

Know the various second line treatment options

for psoriasis

Phototherapy

Acitretin

Methotrexate

Cyclosporin

Understand the difficulties, physical

and psychological, experienced by

patients

Dermatology quality of life index

> Pain, itching, soreness, stinging

> Embarrassment and self consciousness

> Effect on shopping or looking after the home/garden

> Clothes

> Social/leisure activities

> Problems with partner, close friends or relatives

> Sexual difficulties

> Problems from treatment

Psoriatic Nail Disease

> Rarely seen without skin psoriasis.

> Nail pitting

> Onycholysis

> Subungual hyperkeratosis

> Beau’s lines

> Fungal nail infections

Diagnosis

> Typically clinical

> Nail biopsy/cutting

Treatment of nails

> Treat any infection

> Podiatrist for painful toenails

> Steroids (topical/injected)

> Phototherapy

> Nail removal

Thank You

Any questions?