Treatment of nail psoriasis with efalizumab: a preliminary study

Nail involvement is common in psoriasis, affecting 50% to 80% of all patients with the disorder. Pain may accompany nail involvement, restricting daily living activities, and therapy is limited by issues of efficacy and safety. The cases of 4 participants who had been enrolled in a 3-year study of efalizumab for the treatment of chronic moderate to severe plaque psoriasis are presented in this preliminary study. In addition to the diagnosis of moderate to severe plaque psoriasis, each participant discussed in this report presented with nail involvement. These participants achieved clearance of their nail psoriasis within 19 to 33 weeks of efalizumab therapy. None of the participants demonstrated adverse effects during efalizumab therapy. Our experience with these participants suggests that efalizumab may help to improve psoriasis affecting the nails when used for the treatment of chronic moderate to severe plaque psoriasis.