Treatment of inflammatory nail disorders
Article first published online: 4 DEC 2012
© 2012 Wiley Periodicals, Inc.
Volume 25, Issue 6, pages 525–534, November/December 2012
How to Cite
Dehesa, L. and Tosti, A. (2012), Treatment of inflammatory nail disorders. Dermatologic Therapy, 25: 525–534. doi: 10.1111/j.1529-8019.2012.01516.x
- Issue published online: 4 DEC 2012
- Article first published online: 4 DEC 2012
- lichen planus;
- 20 nail dystrophy;
- alopecia areata;
- autoimmune bullous disorders;
This article provides an updated review on diagnosis and treatment of inflammatory nail disorders including psoriasis, lichen planus, trachyonychia, and autoimmune bullous disorders. Despite the significant negative repercussion of the nail psoriasis in the quality of life of patients, treatment is often not sufficiently effective. The efficacy of topical therapies is limited to nail bed psoriasis. Intralesional corticosteroid injections are extensively utilized in nail matrix psoriasis. Systemic immunosuppressant drugs such as methotrexate and cyclosporine have shown efficacy. Biologics, particularly infliximab and etanercept, have also demonstrated high efficacy in the treatment of severe nail disease. Nail matrix lichen planus can cause nail atrophy and irreversible nail scarring and requires prompt treatment with systemic steroids. There is not gold standard therapy for trachyonychia, but in most cases the nail signs improve spontaneously and treatment is not necessary. Nail changes in pemphigus and other autoimmune disorders respond promptly to systemic therapy with steroids and immunosuppressants.