This document provides information about psoriasis and psoriatic nails. It lists the systemic complications of severe psoriasis such as psoriatic arthritis, uveitis, and risk of chronic kidney disease. It also identifies possible aggravating factors for psoriasis including chronic infections, stress, scratching, excessive alcohol, obesity, and climate changes. Finally, it discusses treatment options for psoriasis including topical treatments as well as second-line options like phototherapy, acitretin, and methotrexate. It also notes the physical and psychological difficulties patients may experience.

1. Psoriasis and psoriatic
nails
Jessica Peter Roscoe

2. A little about Psoriasis...

3. Be familiar with the different clinical presentations
of psoriasis

5. List the systemic complications
of severe psoriasis
> Psoriatic arthritis
> Uveitis
> Risk of CKD

6. List at least five possible
aggravating factors for psoriasis
> Chronic infections
> Stress
> Scratching
> Excessive alcohol
> Obesity
> Climate changes

7. 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?

8. Know the various second line treatment options
for psoriasis
Phototherapy
Acitretin
Methotrexate
Cyclosporin

9. 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

10. Psoriatic Nail Disease
> Rarely seen without skin psoriasis.
> Nail pitting
> Onycholysis
> Subungual hyperkeratosis
> Beau’s lines
> Fungal nail infections

15. Diagnosis
> Typically clinical
> Nail biopsy/cutting

16. Treatment of nails
> Treat any infection
> Podiatrist for painful toenails
> Steroids (topical/injected)
> Phototherapy
> Nail removal

17. Thank You
Any questions?