Psoriasis nails
Psoriasis of the nails can have a variety of presentations depending on which part of the nail apparatus the psoriatic process involves.If the nail matrix at the base of the nail is involved then you get pitting, occassionally furrows and often a crumbling nail plate.If the nail bed is involved then you get onycholysis or separation of the nail from the nail bed.People often misinterpret this as a fungal infection.Treatment of this condition is very limited.Topical steroid lotions rarely penetrate the posterior nail fold adequately to alter the process.Intralesional steroid injection is very painful.Methotrexate orally can be used for serious nail disease.
Do others have any other effective treatments? View Images
posted by Dr Ian McColl at 9:49 PM
3 Comments:
Treatment of this condition is very limited.Topical steroid lotions rarely penetrate the posterior nail fold adequately to alter the process.Intralesional steroid injection is very painful.Methotrexate orally can be used for serious nail disease.Does anyone have other alternatives?
9:58 PM
I suppose matrix and bed are affected in this particular case as pitting and onycholysis are evident. Systemic therapy including MTX, cyclosporin and PUVA used to treat chronic plaque psoriasis on the rest of the body should alter the nail scene as well. What do you think?
8:16 PM
I used Methotrexate orally in one patient with very severe psoriasis of the nails in conventional dosage of 15mgs a week with excellent results.Surprisingly she did not relapse when the drug was withdrawn.I have not used puva for psoriatic nails but as uva should penetrate a nail it should work.
4:33 AM
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