Difficult-to-Treat Psoriasis: Gaining Control of Palmoplantar and Nail Psoriasis.

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Presentation transcript:

Difficult-to-Treat Psoriasis: Gaining Control of Palmoplantar and Nail Psoriasis

Palmoplantar Psoriasis: Epidemiology

Palmoplantar Psoriasis: Phenotypes

Palmoplantar Psoriasis: Plaque Type

Nail Psoriasis: Burden of Disease

Poor Efficacy of Topical Agents in Palmoplantar and Nail Psoriasis

Impairment of Quality of Life in Patients With Palmoplantar Psoriasis

Limited Systemic Therapeutic Options in Palmoplantar Psoriasis

IL-17A Expression in Subtypes of Psoriasis

Patient Case Presentation

Patient Treatment History

Impact on Patient Hands

Clinicopathologic Features of Palmoplantar Pustulosis and Palmoplantar Psoriasis

Palmoplantar Psoriasis

Palmoplantar Psoriasis: Therapies

General Questions/Considerations

REACH Study Design

REACH: PGA Clear or Almost Clear

Increased Expression of IL-17A in Palmoplantar Pustular Psoriasis and Palmoplantar Pustulosis

GESTURE Study Design

GESTURE Study: ppIGA 16 Week Results

GESTURE Study: ppPASI 16 Week Results

GESTURE Study: Conclusions

UNCOVER-2: Study Design Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis

UNCOVER-2: Effect of Ixekizumab on Palmoplantar Plaque Psoriasis

Summary: Palmoplantar Plaque Psoriasis

Nail Psoriasis

Prevalence of Nail Psoriasis

Anatomy of the Nail

Clinical Manifestation: Nail Matrix Psoriasis

Clinical Manifestation: Nail Bed Psoriasis

The Burden of Nail Psoriasis

Nail Psoriasis: A Window to More?

Nonsystemic Treatment Options for Nail Psoriasis

Efficacy of MTX and CyA in Nail Psoriasis

Determining the NAPSI

Acitretin and Nail Psoriasis

ESTEEM 1: Apremilast vs Placebo in Nail Psoriasis

ESTEEM 1 and 2: Outcomes at Weeks 16 and 32*†

Mean Percent Improvement of Target Nail NAPSI: Infliximab

Nail Symptoms With Adalimumab Compared With Placebo

Ustekinumab Effects on Nail Psoriasis

Secukinumab in Nail Psoriasis (PASI ≥12, BSA ≥10, fingernail NAPSI ≥16, nails involved ≥4)

Secukinumab in Nail Psoriasis: Clinical Example

Ixekizumab in Nail Psoriasis: Phase 2

The Problem of Quantification: Splinter Hemorrhages/Bleeding

NAPPA: A Novel Superior Tool

Nail Psoriasis: Outlook and Conclusions

Concluding Remarks

Abbreviations

Abbreviations (cont)

Abbreviations (cont)