ABSTRACT
For persons with more severe nail psoriasis involving breakdown of the entire nail plate, cloth wraps can be used to strengthen and create a nail plate for adornment. A simple nail acrylic will not be able to create a smooth surface and the nail will not be strong enough to resist flaking and cracking. Cloth wraps provide reinforcement across the entire nail plate, but are most appropriate for female patients ( Fig. 41.1 ). A cloth wrap is created by placing a layer of acrylic over the nail plate, as described previously. Before acrylic dries, a piece of silk or linen material is placed in the acrylic sized to fit the nail. Once this dries in place, another layer of acrylic is placed on top to imbed the cloth between two acrylic layers ( Fig. 41.2 ). The nail can then be painted to camouflage the cloth. This technique is very effective in severely dystrophic female psoriatic nails.
