ABSTRACT

Nail psoriasis affects approximately 50% of psoriasis patients and in many cases causes functional impairment in manual dexterity, pain and psychological stress. It is often overlooked, not treated effectively. Physicians often believe that the condition is difficult to treat. The risks of systemic conventional therapy are not justified and the difficulty of delivering effective topical drugs to the nail unit is a big challenge for physicians. Hence many psoriasis patients do not receive an effective treatment for nail disease. Recently, systemic therapy with biologic agents targeted against tumour necrosis factor alpha (TNF-α) has found a place in the management of psoriasis and psoriatic arthritis, and their effects on nail psoriasis have been investigated. The aim of this article is to evaluate the response of nail psoriasis to biological agents and compare the effectiveness of three different TNF-α antagonists (infliximab, adalimumab and etanercept).