Nail
psoriasis is common among patients with plaque
psoriasis or
psoriatic arthritis and has a detrimental effect on quality of life. However, there are currently no standardized therapeutic regimens for nail
psoriasis. Traditional treatments for nail
psoriasis, which include topical, intralesional, and oral
therapies, may be time-consuming, painful, or unsafe when administered long term.
Biologic therapies have demonstrated efficacy for plaque
psoriasis and
psoriatic arthritis; these
therapies may be particularly promising for the treatment of nail
psoriasis as both groups of patients have an elevated incidence of nail dystrophy. The
biologic therapies adalimumab,
alefacept,
efalizumab,
etanercept, and
infliximab have demonstrated clinically important nail
psoriasis improvements using the Nail
Psoriasis Severity Index, a helpful tool that, upon validation, will allow comparison across treatments and trials. Large-scale, long-term trials using standardized outcome measures are needed to further evaluate
biologic therapies for the treatment of nail
psoriasis.