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National Psoriasis Foundation offers nail psoriasis best practices

In a literature review, the National Psoriasis Foundation developed treatment recommendations for four nail psoriasis possibilities.

As clinical data are limited for the condition, comparing treatment options is a challenge for physicians based on the current literature, according to the authors.

In patients with disease specific to the nails, the NPF recommends high-potency topical corticosteroids with or without calcipotriol, in addition to intralesional corticosteroids which can secondarily be considered.

For significant nail disease where topical therapy has failed, the authors recommend treatment with adalimumab, etanercept, intralesional corticosteroids, ustekinumab, methotrexate and acitretin.

For significant skin and nail disease adalimumab, etanercept and ustekinumab are highly recommended. In addition to methotrexate, acitretin, infliximab and apremilast.

Lastly, in a patient with significant nail, skin and joint disease: adalimumab, etanercept, ustekinumab, infliximab, methotrexate, apremilast and golimumab are recommended, in decreasing order of effectiveness.

These treatment recommendations from the Medical Board of the National Psoriasis Foundation aim to help guide treatment decisions for clinicians.