فهرست نشریات علمی دسترسی آزاد ایران

Nail psoriasis is a common, chronic manifestation of psoriasis that significantly impairs patients' quality of life. It presents with clinical signs such as nail thickness and discoloration. While numerous treatments exist, topical corticosteroids are a therapeutic cornerstone. However, a comprehensive synthesis of their specific impact on key clinical and patient-reported outcomes is needed. This systematic review aims to evaluate the evidence on the effects of topical corticosteroids on nail thickness, discoloration, and quality of life in patients with nail psoriasis.Following the PRISMA 2020 guidelines, a systematic search was conducted across PubMed, Springer, Semantic Scholar, and Google Scholar. Studies were included if they were RCTs, systematic reviews, or prospective cohorts evaluating topical corticosteroids for nail psoriasis in adults, with a duration of at least four weeks and reporting on nail thickness, discoloration, or quality of life. After screening 966 records and assessing 581 for eligibility, 27 studies were included in the final analysis. The review found a significant lack of specific data on the primary outcomes. Only one of the 27 studies mentioned nail thickness, and none reported on discoloration. In contrast, 14 studies assessed quality of life, most commonly with the Dermatology Life Quality Index (DLQI). These studies consistently showed that effective treatment led to significant improvements, with quality of life impairment reductions reaching up to 77.8%. Comparative analyses often revealed similar efficacy between topical corticosteroids and other interventions. The safety profile was consistently favorable, with only mild, localized adverse events reported. The reliance on composite scores such as the Nail Psoriasis Severity Index (NAPSI) in the literature likely obscures the true effects of treatments on individual nail parameters, explaining the data gap for thickness and discoloration. Topical corticosteroids are a safe and effective component in the management of nail psoriasis, substantially improving patient quality of life. Future clinical trials should prioritize the measurement and separate reporting of specific outcomes such as nail thickness and discoloration to provide more clinically useful data.