Comparative Study of Intralesional Methotrexate Versus Intralesional Triamcinolone Acetonide in Treatment of Nail Psoriasis

The goal of this clinical trial is to compare methotrexate injections with triamcinolone acetonide injections for treating nail psoriasis. Nail psoriasis can cause nail pitting, discoloration, thickening, and separation of the nail from the skin underneath. The study will also compare the safety of these treatments. The main questions it aims to answer are: * Which treatment produces greater improvement in nail psoriasis? * What side effects do participants experience with each treatment? Researchers will compare methotrexate with triamcinolone acetonide. Both medications will be injected intralesionally into the affected nail area. Participants will: * Receive intralesional injections according to the study treatment plan. * Attend clinic visits to assess changes in their affected nails and check for side effects. * Report any pain, discomfort, or other medical problems experienced during the study.

Inclusion Criteria: 1. Patients with bilateral clinically significant nail psoriasis resistant to different treatment modalities. 2. Patients who did not receive any topical or systemic treatment for nail psoriasis in the preceding 3 months and throughout the study. Exclusion Criteria: 1. Patients with concomitant onychomycosis. 2. Patients with other nail disorders and diseases that interfere with the procedures and results, including nail trauma. 3. Patients using concomitant drug therapy affecting the nail. 4. Patients with concomitant other dermatological disease or any systemic disease. 5. Pregnancy and lactation.