Abstract
Treatment of severe nail psoriasis poses a particular challenge due to the anatomy of the nail, small surface area involved, and frequent irritation to fingertips from use of the hands.1,2 Nail psoriasis can be particularly devastating to affected patients as it is easily visible, leading to emotional distress, potential social ostracization and loss of work opportunities and loss of function with performing fine work with the hands.1,2 Being aware of which nail manifestations will present clinically depending on the nail structure affected by psoriasis, which first-line treatments are most efficacious, and when to consider systemic treatments can help guide treatment based on a patient’s preferences and other health conditions
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