Nail psoriasis

Psoriasis of the nails can be an isolated phenomenon or it can be a part of a generalized psoriasis.
Typical psoriatic manifestation in nails is the appearance of translucent areas in the nail, the "oil-drop" phenomenon.
Nail pits can also be present. These pits are arranged longitudinally on the nail and generally appear 1/3 to 2/3 of the way down the nail.
Psoriatic nails can also be thickened. Onycholysis is common.

Treatment:

• Although spontaneous remission can occur, there is no good treatment for psoriasis of the nails.
• Topical steroids applied to the proximal nail folds may occasionally be effective but usually this treatment is not effective.
• Intralesional glucocorticoid injection of the proximal nail fold is extremely painful and only sometimes successful.
• Systemic therapy of generalized psoriasis will often result in clearing of the nails but systemic therapy with cyclosporine or methotrexate is not indicated for the nail disease alone.
• Trauma to the nail should be avoided.

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