Treatment of Psoriasis in Nail Psoriasis

Nail psoriasis is a distinct manifestation of psoriasis affecting the nail unit, with therapeutic requirements that differ from those of cutaneous disease. A targeted topical approach forms the basis of first-line management.

Clinical scenario: Psoriasis presenting with nail psoriasis — nail unit involvement that calls for a dedicated treatment strategy distinct from general plaque management.

First-line approach — partial overview

Management is centred on topical therapy directed at the nail unit, with a vitamin D analogue-based regimen among the first-line options — the complete protocol, including specific agents, combinations, and clinical guidance, is available in full below.

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References

DOI: 10.1016/j.jaad.2020.07.087

Topical vitamin D analogues combined with betamethasone dipropionate can be used for the treatment of nail psoriasis to reduce nail thickness, hyperkeratosis, onycholysis, and pain.

Topical tazarotene can be used for the treatment of nail psoriasis.

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