1. Moderate to Severe Psoriasis Slideshow
2. Psoriasis Quiz: Test Your Medical IQ
3. How Much Is Psoriasis Affecting Your Life?

Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Your doctor may prescribe any of the following medications:

• Creams or ointments to rub on and around the nail, including steroid, topical vitamin A (tazarotene) or vitamin D derivatives (calcipotriene or calcitriol), antimetabolite drugs (such as 5-fluorouracil, which is also used to treat certain cancers) or, occasionally, antifungal solutions may be needed if a fungus infection is present. However, delivery of medications to the nail area is difficult because of the barrier presented by the nail plate. Topical treatments (applied directly to the nail) may not be effective in all cases.
• Steroids applied to the skin under your nail or injected under the nail; injection under the nail may be more effective than when steroids are applied in cream or ointment form.
• PUVA (This therapy is a combination of the prescription medicine, psoralen, and exposure to UVA ultraviolet light.)
• Systemic therapy if you have both skin and arthritis symptoms or if your skin and nail symptoms are severe (Systemic therapy is medication that spreads throughout your body. It is often in pill or injectable form, including methotrexate tablets, and injectable etanercept [Enbrel], adalimumab [Humira], as well as infusible infliximab [Remicade].)

See the article Understanding Psoriasis Medications for more information.

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