Nails
In some cases, nail changes may improve
spontaneously, but no treatment can be relied
on to act as a ‘cure’. Amongst the choices are
calcipotriol twice daily to the nail folds, high
potency topical corticosteroids for a limited period,
intralesional triamcinolone to the proximal nail
folds, topical 5-fluorouracil cream to the matrix,
photochemotherapy or systemic methotrexate
retinoids, ciclosporin or biologics. These severe cases
are best managed by a referral to a dermatologist.
Secondary fungal infection would require treatment
with an antifungal agent (DermNet NZ, 2013).