Nail psoriasis may be improved by injecting corticosteroids into the nail bed. The approach is painful and the response often temporary.
Systemic agents are rarely given when the nails only are affected. They may improve the nail dystrophy when given to treat widespread skin disease.
Secondary infection with Pseudomonas or Candida may occur and produce discoloration. Treat the pseudomonas with 4% thymol in chloroform or 0.3% gentamicin lotion. Treat Candida with 1% clotrimazole. Both are given under the nail.
Patients should be advised to keep their nails short. Chiropody is helpful for patients with marked nail thickening.
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