Reporte de caso: psoriasis ungueal como única manifestación cutánea, un reto diagnostico

Psoriasis is defined as a chronic inflammatory disease with a strong genetic background. The prevalence of psoriasis ranges from 1 to 2% of the population. Over lifetime up to 50% of psoriatics present nail psoriasis, 80% in psoriatic arthritis and 1-5% in patients with nail involvement as the only skin manifestation (1, 2). Two types of nail involvement can be characterized: Nail matrix involvement, and nail bed involvement. The diagnosis is made with clinical signs, with help in some cases of dermoscopy and histopathology (3-5). Imaging of the nail unit can be performed to assess nail alterations, therefore increasing diagnosis in difficult cases. We present a case of nail psoriasis in absence of cutaneous lesions in which nail ultrasonography takes especial relevance in the diagnosis.