Treatment of inflammatory nail disorders

Luis Dehesa, Antonella Tosti

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)525-534
Number of pages10
JournalDermatologic Therapy
Issue number6
StatePublished - Nov 1 2012


  • 20 nail dystrophy
  • alopecia areata
  • autoimmune bullous disorders
  • biologics
  • lichen planus
  • pemphigoid
  • pemphigus
  • psoriasis
  • trachyonychia

ASJC Scopus subject areas

  • Dermatology


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