Medication-Assisted Treatment of Nail Psoriasis

Abstract

Nail involvement occurs in 80–90% of patients with plaque psoriasis and is considerably more
prevalent in psoriatic arthritis sufferers. This review is the result of a systematic review of the literature
and includes information on topical, intralesional, conventional systemic, biologic systemic, and nonpharmacological treatments for nail psoriasis. According to existing research, all anti-tumor necrosis
factor (TNF), anti-interleukin (IL)-17, and anti-IL-12/23 antibodies approved for plaque psoriasis and
psoriatic arthritis are extremely effective treatments for nail psoriasis. Conventional systemic
medications for nail psoriasis, such as methotrexate, cyclosporine, acitretin, and apremilast, as well as
intralesional corticosteroids, may also be beneficial. Additionally, topical therapies such as
corticosteroids, calcipotriol, tacrolimus, and tazarotene have been demonstrated to be effective in the
treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment methods
such as phototherapy, photodynamic therapy, laser therapy, and numerous radiotherapeutic possibilities
are discussed but cannot be recommended as first-line therapy. Additionally, this analysis concludes
that the absence of a credible core set of outcome measures for nail psoriasis trials impairs
interpretation and is urgently required.