Nail involvement has started playing a major role in the overall assessment and management of psoriatic disease. Biologics indicated for moderate to severe chronic plaque
psoriasis are shown to be beneficial in
nail disease. This study aimed to assess and compare the serum levels of TNF-α,
IL-12/23 p40, and
IL-17 in psoriatic patients with and without nail involvement. 52 consecutively selected patients with chronic plaque
psoriasis were included in this cross-sectional study. Patients were studied and analyzed after they had been divided into 2 groups regarding the presence (n = 24) or not (n = 28) of nail
psoriasis. The mean serum levels of TNF-α were significantly higher in the group of psoriatic patients with nail lesions compared to those without (t-test; 5.40 ± 1.17 versus 3.80 ± 1.63, P = 0.026). However, the median serum levels of both
IL-12/23 p40 (Mann-Whitney; 92.52 (34.35-126.87) versus 150.68 (35.18-185.86), P = 0.297) and
IL-17 (Mann-Whitney; 28.49 (0.00-28.49) versus 8.59 (0.00-8.59), P = 0.714) did not significantly differ between the 2 groups. These results confirm the important role of TNF-α in the pathogenesis of nail
psoriasis and may suggest that anti-TNF agents could be more beneficial in psoriatic
nail disease than agents targeting
IL-12/23 p40 or
IL-17 and its receptors.