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

3. Palmoplantar Psoriasis: Epidemiology

4. Palmoplantar Psoriasis: Phenotypes

5. Palmoplantar Psoriasis: Plaque Type

6. Nail Psoriasis: Burden of Disease

7. Poor Efficacy of Topical Agents in Palmoplantar and Nail Psoriasis

8. Impairment of Quality of Life in Patients With Palmoplantar Psoriasis

9. Limited Systemic Therapeutic Options in Palmoplantar Psoriasis

10. IL-17A Expression in Subtypes of Psoriasis

11. Patient Case Presentation

12. Patient Treatment History

13. Impact on Patient Hands

14. Clinicopathologic Features of Palmoplantar Pustulosis and Palmoplantar Psoriasis

15. Palmoplantar Psoriasis

16. Palmoplantar Psoriasis: Therapies

17. General Questions/Considerations

18. REACH Study Design

19. REACH: PGA Clear or Almost Clear

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

21. GESTURE Study Design

22. GESTURE Study: ppIGA 16 Week Results

23. GESTURE Study: ppPASI 16 Week Results

24. GESTURE Study: Conclusions

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

26. UNCOVER-2: Effect of Ixekizumab on Palmoplantar Plaque Psoriasis

27. Summary: Palmoplantar Plaque Psoriasis

28. Nail Psoriasis

29. Prevalence of Nail Psoriasis

30. Anatomy of the Nail

31. Clinical Manifestation: Nail Matrix Psoriasis

32. Clinical Manifestation: Nail Bed Psoriasis

33. The Burden of Nail Psoriasis

34. Nail Psoriasis: A Window to More?

35. Nonsystemic Treatment Options for Nail Psoriasis

36. Efficacy of MTX and CyA in Nail Psoriasis

37. Determining the NAPSI

38. Acitretin and Nail Psoriasis

39. ESTEEM 1: Apremilast vs Placebo in Nail Psoriasis

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

41. Mean Percent Improvement of Target Nail NAPSI: Infliximab

42. Nail Symptoms With Adalimumab Compared With Placebo

43. Ustekinumab Effects on Nail Psoriasis

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

45. Secukinumab in Nail Psoriasis: Clinical Example

46. Ixekizumab in Nail Psoriasis: Phase 2

47. The Problem of Quantification: Splinter Hemorrhages/Bleeding

48. NAPPA: A Novel Superior Tool

49. Nail Psoriasis: Outlook and Conclusions

50. Concluding Remarks

51. Abbreviations

52. Abbreviations (cont)

53. Abbreviations (cont)