Nail Psoriasis in Older Adults: Intralesional, Systemic, and Biological Therapy

Dermatol Clin. 2021 Apr;39(2):195-210. doi: 10.1016/j.det.2020.12.012. Epub 2021 Feb 10.

Abstract

Psoriasis may affect the skin, scalp, joints, and nails and is common in older adults. Intramatrical injections with triamcinolone acetonide are safe and effective in older individuals. Conventional systemic medications are relatively effective, but side effects, including laboratory abnormalities and drug interactions, are particularly common among older adults. Biologic medications have shown excellent efficacy in treating nail psoriasis. Their safety profile is favorable, but data assessing long-term safety are lacking. Randomized controlled trials in older adults exclusively are necessary to develop evidence-based treatment guidelines in this population.

Keywords: Acitretin; Cyclosporine; Methotrexate; Nail psoriasis; Nails; Older adults; Psoriasis; Psoriatic arthritis.

Publication types

  • Review

MeSH terms

  • Aged
  • Biological Therapy
  • Humans
  • Nail Diseases* / drug therapy
  • Nails
  • Psoriasis* / drug therapy