The same treatments you get for skin psoriasis can also treat your nail psoriasis. Because your nails grow slowly, it can take time before you see any improvements in the newly grown parts of your nail. The nails are part of the skin, so it is perhaps not surprising that a skin disease such as psoriasis can affect the nails. Nail psoriasis is perhaps the most difficult part of psoriasis to treat. Most psoriatic nail disease occurs in patients with clinically evident psoriasis; it only occurs in less than 5 of patients with no other cutaneous findings of psoriasis.
The diagnosis and treatment of other manifestations of psoriasis are reviewed separately. The proximal nail matrix forms the superficial portion of the nail plate. The symptoms of nail psoriasis can range from mild to severe, and it is easy to misdiagnose as a fungal infection. People whose psoriasis occurs in areas of injury to the skin (known as Koebner Phenomenon) may find that a nail injury or infection triggers nail psoriasis, but this is not always the case. There are not currently any cures fro nail psoriasis, but there are treatments that can be used to mitigate against any additional symptoms, such as fungal infections of the nail.
9 As of April 2009, an assessment of the evidence for the efficacy and safety of the treatments for nail psoriasis is in progress. Treatment options for moderate to severe psoriasis include topical and systemic medications, phototherapy, and excimer laser, Combination therapies are often more effective than one treatment alone. Plaque psoriasis leads to skin patches that start off in small areas, about 1/8 of an inch wide. Over half of patients with psoriasis have abnormal changes in their nails, which may appear before other skin symptoms. Systemic treatments for psoriasis are generally prescribed after consultation with a dermatologist. Tumor Necrosis Factor Inhibitors Etanercept is a cloned and engineered fusion protein made of two p75 TNF receptors and the Fc portion of human IgG.
Nail psoriasis can be treated effectively using topical treatments, intralesional treatments, and systemic treatments, but an optimal effect may take up to 1 year. It is known that psoriasis on visible areas of the skin, such as the face and hands, may have a substantial negative impact on physical, psychological, and social dimensions of quality of life (QoL) 7 11. 308nm Excimer Laser for Treatment of Fingernail Psoriasis (NAPSI). Excimer laser is a form of targeted ultraviolet light therapy that has been successfully used to treat isolated psoriatic plaques on difficult to treat areas such as scalp or palms. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. Severe 20-nail psoriasis successfully treated by low dose methotrexate.