Nail psoriasis - a chronic disease that requires long-term treatment.Therapy selects dermatologist considering the severity of the disease, the severity of the external manifestations, concomitant diseases, the effectiveness of previous treatments.The main directions in the treatment of nail psoriasis:
With them begins the treatment of psoriasis nail.In mild form of the disease, such funds may be the main method of treatment.The main groups of products for topical application:
Glucocorticosteroids - hormones of the adrenal cortex, has a pronounced anti-inflammatory and anti-allergic effect.For the treatment of nail psoriasis ointments and creams containing these substances.These include tools such as "Advantan", "sinaflana", "Triderm" prednisolone ointment and many others.There are products of this group in the form of nail polish ("Clobetasol").Topical Corticosteroids should not be used if you are sensitive to them, viral skin diseases (eg, herpes zoster), skin manifestations of syphilis and tub
Preparations of vitamin D topical inhibit cell proliferation of nail plates, slowing the progression of psoriasis.They are highly effective.These include, for example, "Dayvoneks" ("Psorkutan") in the form of ointments and creams.These funds shall be imposed for violations of calcium metabolism in the body, as well as children.The most common side effects - skin irritation and itching around the nails.When used properly, calcium metabolism disorders using vitamin D drugs are unlikely.Keep in mind that these funds can not be used simultaneously with salicylic acid.They combine well with corticosteroids.
Tar - a natural substance.It inhibits the proliferation of cells of the nail, but this effect is less pronounced than in preparations of vitamin D. tar preparations have anti-inflammatory effects, as well as contribute to soften dead skin cells (keratolytic effect).They are contraindicated in inflammatory processes of the skin and nails.Their use may cause irritation and itching of the skin, nail varnish in a dark color.For drugs of tar is "Berestol."
dermotropic substance .By modern means of this group include dithranol preparations - "Tsignoderm" and "Ditrastik" a pen "Psoraks" as an ointment, and others.These resources inhibit cell proliferation.They can cause skin irritation.Dithranol preparations stained nails, skin, clothes, so they should be applied carefully.Assign these funds should be a doctor, because they are contraindicated in some forms of psoriasis.
Retinoids for topical use suppress inflammation and inhibit the proliferation of cells of the skin and nails.The main drug in this group is "tazarotene" and its analogues.It is suitable for long-term use, it is possible combination with other drugs for the treatment of psoriasis."Tazarotene" is irritating, so it can not be used in case of damage or inflammation of the skin.
Salicylic acid psoriasis nail is used to soften and remove dead skin cells of the nail.It is widely used in combination with corticosteroids.This means a high concentration may cause irritation of the skin, so you need to use it with caution.
5-fluorouracil applied as a 1% solution of the band or in the form of a cream.It can cause side effects such as tissue destruction nail hyperpigmentation, skin irritation.Therefore, it is recommended to first apply one nail to assess side effects.
With the ineffectiveness of local treatment, as well as a combination of skin and nail psoriasis can be assigned through system actions that inhibit cell proliferation nail:
Cyclosporine is a very effective drug for the treatment of nail psoriasis.Chronic administration is necessary to monitor kidney function using biochemical analysis of blood, as well as to regularly measure blood pressure.Given the likelihood of side effects related to cyclosporine drugs reserve psoriasis nail.
methotrexate as a treatment for isolated nail psoriasis has not been studied.However, it is known that when it is used for other forms of psoriasis nail condition is substantially improved.The drug has many side effects and contraindications.
Systemic retinoids (Etretinat, Acitretin) appointed in severe cases.They are not prescribed to women of childbearing age because of teratogenic effects on the fetus at a possible pregnancy.The drugs can cause dry mucous membranes, itchy skin, hair loss and other unpleasant side effects.Their use should regularly monitor liver function by using biochemical analysis of blood.
These funds have recently begun to be studied.These include:
Monoclonal antibodies (Rituximab) applied under strict indications.They can cause severe side effects, even death.
biological response modifiers (Alefacept) have an average efficiency, but their advantage is well tolerated.
tumor necrosis factor blockers (infliximab) is very promising for the treatment of nail psoriasis.Some studies have indicated the complete disappearance of symptoms of psoriatic lesions after treatment.Infliximab may cause serious allergic reactions.Nevertheless, it may be considered more secure than traditional systemic medications.
problems in the treatment of nail psoriasis are low efficiency of local therapy, the high toxicity of drugs for systemic treatment, long-term rates, the need for maintenance treatment.
Nevertheless, in this area there is progress.Studied the biological action of the drug, many new agents are in clinical trials.In the near future is likely emergence of new treatment options for nail psoriasis.