Fast Five Quiz: Nail Psoriasis

William James, MD

Disclosures

October 24, 2021

Attaining optimum therapeutic concentrations of topical medications is difficult with nail psoriasis owing to the presence of the nail plate, which can act as an impermeable physical barrier. Identifying the precise anatomical location of psoriatic nail disease is therefore essential for knowing how and where topical medications should be applied. In cases involving the nail bed, the diseased nail should first be trimmed as short as possible, and the topical medication should then be applied directly to the hyponychium, without occlusion.

Topical products that contain corticosteroids are not recommended for more than 12 weeks of use for nail disease because there have been isolated reports of bone atrophy with persistent use.

A topical combination of a high-potency corticosteroid and the synthetic vitamin D3 derivative, calcipotriol, may benefit some patients.

Learn more about topical therapies for nail psoriasis.

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