Efficacy of Nonablative Bipolar Radiofrequency in the Treatment of Fingernail Psoriasis

Psoriasis is a common chronic systemic disease affecting the skin, nails, and joints. Nails are commonly associated with a greater severity of the disease. Radiofrequency (RF) is a nonionizing radiation that provides energy originating from electric current to generate heat inside the dermis with anti-inflammatory effects. To assess the efficacy of nonablative bipolar radiofrequency in treating fingernail psoriasis. Forty-three affected fingernails were treated with nonablative bipolar RF. Sessions were performed every 2 weeks for 2 months, with a maximum of 5 sessions. The 32-point target nail psoriasis severity index (tNAPSI), ultrasonography, and the physicians' global assessment were used for assessment at baseline, 1 month, and 3 months from the last treatment session. One month after the last RF session, a significant reduction in median tNAPSI score from baseline was recorded (p = .002), with a 58.33% reduction in pit count. The median thickness of subungual hyperkeratosis decreased significantly from baseline (p = .024), and the median score of onycholysis was also significantly reduced (p = .005). Ultrasonography revealed a significant reduction in the median nail matrix, bed thickness, and nail vascularity (p = .020, p < .001, and p = .013, respectively). Radiofrequency may offer a safe and effective treatment modality for fingernail psoriasis.