Nail fold psoriasis L40.8

Sharply limited, periunngual. erythematosquamous changes in psoriasis vulgaris. Cuticles either absent or also hyperkeratotic.

Secondary onychodystrophy with dimpling, longitudinal rippling, transverse bulges, etc. possible.

External treatment is lengthy, requires the patient's utmost patience and consistency, and the results are often unsatisfactory.:

Glucocorticoids under occlusion (e.g. Ecural, Dermatop), possibly as an injection into the nail matrix (e.g. Volon A).

For mild psoriatic nail changes, combination therapies with a urea varnish (e.g. Onypso - 15% urea) or a nail varnish with horsetail extracts, methylsulfonylmethane and hydroxypropylchitosan (Sililevo - not available on prescription) and a topical steroid (e.g. momethasone furoate) are recommended. Several months of therapy are always necessary.

Systemic therapy should be considered in cases of severe nail infestation (daily work is significantly impaired). Therapeutic approaches with fumarates, retinoids, methotrexate are suitable for this. See psoriasis below.