Psoriatic onychodystrophy: Clinical course, diagnosis and therapeutic aspects

Abstract

Psoriatic onychodystrophy is observed in about 80% of patients with psoriasis. Psoriasis can affect two nail structures ― the matrix and the nail bed. Involvement of the nail matrix in the pathological process can lead to the formation of leukonychia, thimble symptom, red spots in the area of the hole and destruction of the nail plate. On the other hand, the lesion of the nail bed is characterized by the formation of onycholysis, subcutaneous hyperkeratosis and subcutaneous hemorrhages. Nail lesions in psoriasis are accompanied by functional disorders and aesthetic defects, and also indicate a severe course of psoriasis. Treatment of psoriatic onychodystrophy includes topical medications, systemic therapy in cases accompanied by extensive skin lesions. This article is an overview of the main clinical features, diagnostic issues and evaluation methods, as well as treatment options for nail psoriasis.