Psoriasis usually affects the skin. But with this type of disease, such as psoriatic arthritis, in 80% of cases, the patient’s nail plates are also affected, that is, psoriatic onychia or onychodystrophy develops. Treatment of nails with psoriasis has some difficulties, takes a long time and is difficult.  

Symptoms of psoriatic onychia

The defeat of the nails in psoriasis manifests itself in the form of transverse or longitudinal stripes on the nail plate, as well as clouding of the nail. In addition, there are several characteristic signs of this disease. These include:

  • a symptom of a thimble, when places depressed on the nail appear, as if on a thimble;
  • rejection of the edge of the nail plate from the nail bed (onychomadesis);
  • a sharp increase in the thickness of the nail (onychokeratosis);
  • minor hemorrhages in the affected nail plate (onychohemorrhage);
  • the shape of the nail is spoon-shaped, that is, concave inward (koilonychia).

Often, the disease is aggravated by a fungal or bacterial infection, which makes the treatment of nails for psoriasis even more difficult and time-consuming, sometimes even months and years.  

Complex of treatment of psoriasis of nails

According to experts, it is almost impossible to completely cure this disease. It is possible to achieve in the process of scrupulous treatment a decrease in the risk of developing concomitant infections, it is possible to achieve remission of the disease, but it has never been possible to completely eliminate its root cause.

Therapeutic methods of treatment should take into account such factors as the timing and duration of onychodystrophy, the extent of the affected area, the stage of nail psoriasis, and the presence of concomitant diseases. In addition, the treatment of nails with psoriasis must necessarily include complex measures, and consist of the following measures:  

  • psycho-emotional preparation of the patient;
  • normalization of hormonal levels and metabolism in the patient’s body;
  • complete cure of the patient’s body from viral, bacterial, fungal or parasitic infections;
  • stabilization of the patient’s digestion, that is, general cleansing of the body.

In the complex treatment of psoriasis of the nail plates, medications and topical agents (creams and medicinal ointments), as well as medicinal herbs and physiotherapy, are necessarily used. Good results are shown by patients adhering to a special diet, and proper nail care.

Drug therapy for nail psoriasis involves the use of drugs such as glucocorticosteroids. However, it is not recommended to take them on your own, without a doctor’s prescription, since this type of drugs belongs to the group of hormonal drugs.

In addition to glucocorticosteroids, it is necessary to take calcium-containing drugs, which have an anti-inflammatory and desensitizing effect on the body.

Since nail psoriasis is accompanied by dyselementosis and vitamin deficiency, patients must take a complex of vitamins and minerals that normalize metabolism, participate in the regeneration of the nail plates and stabilize the general condition of the body. Such substances include vitamins A, E, C, D, P, vitamins of group B, as well as trace elements silicon, selenium, zinc.

Antihistamines (tavegil, diphenhydramine, suprastin) during the treatment of nails with psoriasis also show a good effect.

Local treatments for psoriasis include ointments – prednisolone, hydrocortisone (at the initial stage) and non-halogenated ointments (at an advanced stage of the disease). The best results are shown by means such as Advantan ointment, Dermazolone, Oxycort, Flucinar, Psorkutan cream.

Traditional ointments, which include salicylic acid and tar, are also indicated for use in the treatment of psoriatic onychia. They perfectly relieve skin flaking, soften the nail plate and stop inflammation in the affected areas.

Physiotherapy procedures in the treatment of nail psoriasis are ultraviolet radiation, sometimes with the use of photosensitizers (PUVA therapy), selective phototherapy and laser therapy.  

All the presented methods of treating the disease must be applied in a comprehensive manner, while not forgetting to adhere to a special diet and provide nails with regular, proper care.

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