Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar;90(3):585-596.
doi: 10.1016/j.jaad.2023.11.024. Epub 2023 Nov 24.

Nail psoriasis and nail lichen planus: Updates on diagnosis and management

Jonathan K Hwang  1 , Chander Grover  2 , Matilde Iorizzo  3 , Mark G Lebwohl  4 , Bianca M Piraccini  5 , Dimitris G Rigopoulos  6 , Shari R Lipner  7
Affiliations
Review

Nail psoriasis and nail lichen planus: Updates on diagnosis and management

Jonathan K Hwang et al. J Am Acad Dermatol. 2024 Mar.

Abstract

Background: Inflammatory diseases of the nail, including nail psoriasis and nail lichen planus, are associated with significant disease burden and have a negative impact on quality of life. Diagnosis is often delayed, especially when patients present without cutaneous findings. Therefore, recognizing clinical signs and symptoms of inflammatory nail diseases, and initiating timely and appropriate treatment, is of utmost importance.

Objective: We review recent studies on diagnostic techniques, discuss severity grading and scoring systems, and describe consensus treatment recommendations for nail psoriasis and nail lichen planus.

Methods: An updated literature review was performed using the PubMed database on studies assessing diagnostic techniques or treatment modalities for nail psoriasis and nail lichen planus.

Results: Recent studies on diagnostic techniques for inflammatory nail disease have focused on use of dermoscopy, capillaroscopy, and ultrasound modalities. Treatment of these conditions is dichotomized into involvement of few (≤3) or many (>3) nails. Recent psoriatic therapeutics studied for nail outcomes include brodalumab, tildrakizumab, risankizumab, deucravacitinib, and bimekizumab, while emerging treatments for nail lichen planus include JAK inhibitors and intralesional platelet rich plasma injections.

Conclusions: We emphasize the need for increased awareness and expanded management strategies for inflammatory nail diseases to improve patient outcomes.

Keywords: inflammatory; lichen planus; nail; nail diseases; psoriasis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest Dr Lebwohl receives research funds from AbbVie, Amgen, Arcutis, Avotres, Boehringer Ingelheim, Cara Therapeutics, Dermavant Sciences, Eli Lilly, Incyte, Inozyme, Janssen Research & Development, LLC, Ortho Dermatologics, Sanofi-Regeneron, and UCB, Inc, and is a consultant for Almirall, AltruBio Inc, AnaptysBio, Arcutis Inc, AstraZeneca, Avotres Therapeutics, Brickell Biotech, Boehringer Ingelheim, Bristol-Myers Squibb, Castle Biosciences, Celltrion, Corevitas, Dermavant Sciences, EPI, Evommune, Inc, Facilitation of International Dermatology Education, Forte Biosciences, Foundation for Research and Education in Dermatology, Galderma, Genentech, Incyte, LEO Pharma, Meiji Seika Pharma, Mindera, Pfizer, Seanergy, Strata, Trevi, and Verrica. Dr Rigopoulos has provided honoraria for advisory boards, lectures and support for traveling to scientific meetings from AbbVie, Gelgene/Genesis Pharma, Novartis, Janssen, Lilly Pharmaserve, and UCB. Dr Lipner has no conflicts of interest to declare.Her financial disclosures include serving as a consultant for Eli Lilly, Ortho-Dermatologics, Belle Torus Corporation, and Moberg Pharmaceuticals. Author Hwang and Drs Grover, Iorizzo, and Piraccini have no conflicts of interest to declare.

References