title: Treatment of inflammatory nail disorders.
abstract: 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.
authors.affiliation: University of Miami Hospital/Florida Academic Dermatology Center, Miami, Florida 33136, USA.
authors.forename: Luis
authors.initials: L
authors.lastname: Dehesa
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosti
mesh_terms: D001327:Autoimmune Diseases / Q000628:therapy*; D003879:Dermatologic Agents / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008010:Lichen Planus / Q000628:therapy*; D009260:Nail Diseases / Q000628:therapy*; D010789:Phototherapy / Q000379:methods; D011565:Psoriasis / Q000628:therapy*; D012720:Severity of Illness Index
chemical_list: D003879:Dermatologic Agents; D007166:Immunosuppressive Agents