How is nail psoriasis treated?

Updated: Jun 25, 2021
  • Author: Cindy Li, DO; Chief Editor: William D James, MD  more...
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Many treatment options are available after the diagnosis of nail psoriasis is made. The treatments focus on improvement of the functional and psychosocial aspects of psoriatic nail disease.

The treatment options for nail psoriasis include topical corticosteroids, intralesional corticosteroids, psoralen plus ultraviolet light A (PUVA), [10] topical fluorouracil, [11] topical calcipotriol, [12] topical anthralin, [13] topical tazarotene, [14, 15] topical cyclosporine, [16] avulsion therapy, [17] and systemic therapy for severe cases. Onychomycosis (if present) requires antifungal therapy for improvement. Laser and light therapies have emerged as possible cost-efficient, in-office treatments; however, large-scale trials are needed, particularly in consideration for the effects in combination with other current therapies. [18]

For preventive care, keep the nails dry and protect them from trauma to avoid the Koebner effect and possible secondary microbial colonization. In areas of onycholysis, the nail plate should be trimmed to the point of separation for medications to be effective.

At present, no definitive and curative treatment has been agreed upon by medical experts. Discuss all treatment options for psoriatic nail disease with the patient, and choose the best individually tailored regimen.

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