Dermanail. Derma nail, prescription genedur and intralesional steroids can all improve nail psoriasis. The improvement is slow because fingernails will need 6 months to grow out to show the positive effect. Treatment will need to be continued because the inflammation at the nail matrix is still on going.Systemic drugs such as Methotrexate or enbrel, (etanercept) humira, and stelar a will also improve the nails and body.
Meds or surgery. Topical steroids, vitamin a or d derivatives can be tried first. Then intralesional injections of steroids into the nails. Puva or light therapy can be tried. Next are oral medications such as Methotrexate or injectable biologics such as enbrel, humira, or remicade (infliximab). Last resort would be chemical or surgical removal of the nail.