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 long, requires utmost patience and consistency of the patient. The results are often unsatisfactory.:

Glucocorticoids under occlusion (e.g. Ecural, Dermatop), if necessary as 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 - non-prescription) and a topical steroid (e.g. momethasone furoate) are recommended. Always a therapy of several months is necessary.

In case of severe nail infestation (daily work clearly impeded) a system therapy should be considered. Therapy approaches with fumarates, retinoids, methotrexate are suitable for this. See below Psoriasis.