Response of psoriatic nails to oral photochemotherapy

Ten patients with generalized psoriasis, which included nail involvement, were treated with total-body oral photochemotherapy. A combination of methoxsalen and high-intensity ultraviolet A radiation was employed and its therapeutic efficacy in nail psoriasis ascertained. Among the ten patients, there were 26 instances of the following nail signs: pitting, onycholysis, "oil drop" change, subungual hyperkeratosis, nail-plate crumbling, proximal nail-fold psoriasis, and onychorrhexis. Of the 26, eighteen improved by 50% or more. Only pitting failed to respond to therapy in all of the eight patients who had this change.