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Dimitris Rigopoulos - Nail Psoriasis: From A to Z

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Dimitris Rigopoulos Nail Psoriasis: From A to Z

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Nail psoriasis is very common and causes considerable morbidity to patients. With the aid of informative illustrations, this book presents the clinical signs suggestive of nail psoriasis and describes the differential diagnosis of nail abnormalities. Newer methods of diagnosis are considered, and advice is provided on the use of severity evaluation indexes. The available treatments are extensively discussed, with information on the latest options. Selection of the appropriate treatment may be a challenge, so guidance is provided on all factors that should be taken into consideration and on choice of treatment for special categories of patient, such as children and pregnant women. Contributors have been selected from across the world, offering an international perspective on the condition. Nail Psoriasis will be an invaluable up-to-date source of information for dermatologists and will also be of interest to rheumatologists and general practitioners.

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Springer International Publishing Switzerland 2014
Dimitris Rigopoulos and Antonella Tosti (eds.) Nail Psoriasis 10.1007/978-3-319-08810-5_1
1. Epidemiology of Nail Psoriasis
Bertrand Richert 1
(1)
Department of Dermatology, Brugmann, St. Pierre and Queen Fabiola Childrens University Hospitals, Brussels, Belgium
Bertrand Richert (Corresponding author)
Email:
Marie Caucanas
Email:
1.1
1.2
1.3
1.4
Key Features
  • Determining the prevalence of nail psoriasis is utopian.
  • There is a positive correlation with the duration and the severity of skin psoriasis.
  • Males seem to be more affected.
  • Nail psoriasis starts mainly in early adulthood.
  • Nail psoriasis carries a high risk of developing psoriatic arthritis.
1.1 Introduction
Physicians often overlook nail psoriasis, and it is difficult to assess its real prevalence. The vast majority of published studies evaluate the prevalence of nail involvement within a study on skin psoriasis. Moreover, several biases are often encountered. This explains why the documented prevalence of nail psoriasis varies between 6.4 and 81.8 %.
1.2 History
Using PubMed, Ovid MEDLINE and Ovid EMBASE, a literature search was conducted throughout January 2014, using the keywords nail, psoriasis and epidemiology. Thirty-two articles were selected as they were offering enough data. Among them, 16 were prospective; 11 were retrospective. Five used a questionnaire sent to all patients known as having psoriasis from the data of one or several hospitals [].
1.3 Developments
The prevalence of nail psoriasis (NP) has been evaluated through studies on skin psoriasis (see Table ], which is clever, as toenails are not often affected in NP, but nothing looks more like onychomycosis or frictional hyperkeratosis than a hyperkeratotic NP.
Table 1.1
Epidemiologic data from studies dealing with nail psoriasis
Geographical location
Nb
P/R/Q
NPP
A/C
NP M/F ratio
LSPD
LSPS
LPA
1st MCND
2nd MCND
3rd MCND
N/S
Italy []
P
76.9 %
A
79.8/70.4 %
Yesa
Yes
Yes
Onycholysis
Crumbling
SU hyperkeratosis
N
Germany []
3,531
P
40.9 %
A
46/34.8 %
Yes
Yes
Yes
/
/
/
N
Spain []
P
47.4 %
A
53.7/40.2 %
Yes
Yes
Yes
/
/
/
N
France []
1,309
QR
60.8 %
A
/
Yes
/
/
SU hyperkeratosis
Whitish aspect
Small spots
N
Poland []
P
78.3 %
A
/
/
Yes
Yes
SU hyperkeratosis
Pitting
Discoloration
N
The Netherlands []
1,728
QR
79.2 %
A+C
/
Yes
/
/
Pitting
Deformation
Onycholysis
N
The Netherlands []
1,459
QR
66 %
A
50.8 %/48.2 %
/
/
Yes
Pitting
Onycholysis
Oil-drop
N
Greece []
P
66.7 %
A
41.4/58.6 %
No
/
No
Oil drop
Onycholysis
Pitting
N
The USA []
R
17 %
C
/
/
/
/
/
/
/
S
The USA []
P
81.8 %
A
/
/
No
No
Pitting
Onycholysis
Oil drop
N
Canada []
Q
2644 %
A
23/19 %
/
/
Yes
/
/
/
S
Turkey []
R
16 %
A+C
/
/
/
/
Pitting
SU hyperkeratosis
Onycholysis
S
Turkey []
R
21.3 %
C
18.2/23.1 %
/
/
/
Pitting
SU hyperkeratosis
Dyschromia
S
Kuwait []
P
36 %
C
/
/
/
/
Pitting
/
/
S
Kuwait []
P
37.81 %
C
69.87/39.98 %
No
No
No
Pitting
Onycholysis
SU hyperkeratosis
N
Saudi Arabia []
R
26.6 %
A
/
/
/
/
/
/
/
S
Nigeria []
P
15.9 %
A+C
/
/
/
/
/
/
/
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