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Erschienen in: Der Hautarzt 3/2012

01.03.2012 | Leitthema

„Stiefkind“ Nagelpsoriasis

Pathogenese, Diagnostik, Therapie

verfasst von: Dr. C. Kahl, B. Hansen, Prof. Dr. K. Reich

Erschienen in: Die Dermatologie | Ausgabe 3/2012

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Zusammenfassung

Etwa 50% aller Psoriasispatienten weisen eine Nagelbeteiligung als klinisches Korrelat einer psoriatischen Entzündung der Nagelmatrix und/oder des Nagelbettes auf. Die häufigsten Zeichen einer Nagelpsoriasis sind Tüpfel und distale Onycholysen. Der derzeit am häufigsten eingesetzte Score zur Erfassung der Schwere einer Nagelbeteiligung ist der Nail Psoriasis Severity Index (NAPSI). Allerdings werden patientenbezogene Symptome in diesem Index nicht berücksichtigt, obwohl mehr als die Hälfte der Betroffenen zum Teil unter deutlichen physischen und psychischen Einschränkungen leiden. Auffällig ist der Zusammenhang zwischen einer Nagelpsoriasis und dem Risiko einer Gelenkbeteiligung. Die Prävalenz einer Nagelpsoriasis beträgt bei Patienten mit Psoriasisarthritis etwa 70%. Ursächlich für diese Wechselbeziehung scheint der über die Fasern der Strecksehne vermittelte enge anatomische Kontakt zwischen Nagelapparat und distalem Interphalangealgelenk zu sein. Eine Enthesitis kann damit in der Erkrankung des Nagels sichtbar werden. Nagelveränderungen werden aktuell im Therapiemanagement oft nicht ausreichend berücksichtigt. Es gibt nur begrenzte Evidenz zur Wirksamkeit lokaler Therapieformen, mittlerweile liegen aber gute Daten insbesondere zur Wirksamkeit der Biologics und neuerdings auch zu Methotrexat in der Behandlung der Nagelpsoriasis vor.
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Metadaten
Titel
„Stiefkind“ Nagelpsoriasis
Pathogenese, Diagnostik, Therapie
verfasst von
Dr. C. Kahl
B. Hansen
Prof. Dr. K. Reich
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
Die Dermatologie / Ausgabe 3/2012
Print ISSN: 2731-7005
Elektronische ISSN: 2731-7013
DOI
https://doi.org/10.1007/s00105-011-2228-4

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