Managing Nail Psoriasis and Nail Lichen Planus

According to a study published in the Journal of the American Academy of Dermatology, inflammatory nail diseases, such as nail psoriasis and nail lichen planus, significantly impact patients' quality of life and are often diagnosed late, particularly when skin lesions are absent.

A literature review was conducted to explore recent studies focusing on diagnostic approaches and treatment options for nail psoriasis and nail lichen planus. Diagnostic advancements have highlighted the utility of dermoscopy, capillaroscopy, and ultrasound for identifying inflammatory nail conditions. Treatment is divided based on the number of nails affected, with different approaches recommended for those with fewer (≤3) vs many (>3) nails.

For nail psoriasis, recent therapeutic studies have evaluated biologics, such as brodalumab, tildrakizumab, risankizumab, deucravacitinib, and bimekizumab, showing promising outcomes for nail health. In the case of nail lichen planus, emerging treatments include Janus kinase inhibitors and intralesional platelet-rich plasma injections.

In conclusion, increasing awareness and improving diagnostic and treatment strategies for inflammatory nail diseases are essential to improving patient outcomes. By incorporating new diagnostic modalities and expanding treatment options, clinicians can offer more effective and tailored care for patients living with these often-overlooked conditions.

Reference
Hwang JK, Grover C, Iorizzo M, et al. Nail psoriasis and nail lichen planus: updates on diagnosis and management. J Am Acad Dermatol. 2024;90(3):585-596. doi:10.1016/j.jaad.2023.11.024