Background: Treatment of nail psoriasis remains a challenge. Objective: To evaluate the efficacy of a two-compound product of calcipotriol plus betamethasone dipropionate ointment on nail psoriasis in an open-label study. Methods: Twenty-five psoriatic patients with nail involvement and mild cutaneous psoriasis were instructed to apply a calcipotriol-betamethasone valerate ointment formulation once daily for 12 weeks on affected nails. Outcome measures were assessed at baseline and at weeks 4, 8 and 12 using the nail psoriasis severity index (NAPSI). Results: Twenty-two patients having 114 nails involved at baseline with a mean NAPSI of 5.8 ± 1.7 were followed up for 12 weeks. The mean NAPSI at the end of the treatment period was reduced to 1.6 ± 0.6 presenting a 72% improvement. Significant improvement was observed for hyperkeratosis and onycholysis (reduction of mean hyperkeratosis NAPSI from 2.2 ± 0.5 to 0.5 ± 0.1 and mean onycholysis NAPSI from 2.0 ± 0.6 to 0.4 ± 0.2), moderate improvement for oil drops (reduction of mean oil drop NAPSI from 1.2 ± 0.4 to 0.8 ± 0.3) and slight improvement for pitting (reduction of mean pitting NAPSI from 0.8 ± 0.2 to 0.6 ± 0.2). Conclusions: The calcipotriol plus betamethasone dipropionate two-compound ointment, applied once daily for 12 weeks, was shown to improve nail psoriasis.

1.
De Berker D: Diagnosis and management of nail psoriasis. Dermatol Ther 2002;15:165–172.
2.
De Jong EM, Seegers BA, Gulinck MK, Boezeman JB, van de Kerkhof PC: Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients. Dermatology 1996;193:300–303.
3.
McGonagle D, Tan L, Benjamin M: The nail as a muscloskeletal appendage – implications for an improved understanding of the link between psoriasis and arthritis. Dermatology, in press.
4.
Gregoriou S, Kalogeromitros D, Kosionis N, Gkouvi A, Rigopoulos D: Treatment options for nail psoriasis. Exp Rev Dermatol 2008;3:339–344.
5.
Rich P, Scher RK: Nail Psoriasis Severity Index: a useful tool for evaluation of nail psoriasis. J Am Acad Dermatol 2003;49:206–212.
6.
de Berker DA, Lawrence CM: A simplified protocol of steroid injection for psoriatic nail dystrophy. Br J Dermatol 1998;138:90–95.
7.
Cannavò SP, Guarneri F, Vaccaro M, Borgia F, Guarneri B: Treatment of psoriatic nails with topical cyclosporin: a prospective, randomized placebo-controlled study. Dermatology 2003;206:153–156.
8.
Scher RK, Stiller M, Zhu YI: Tazarotene 0.1% gel in the treatment of fingernail psoriasis: a double-blind, randomized, vehicle-controlled study. Cutis 2001;68:355–358.
9.
Rich P, Griffiths CE, Reich K, Nestle FO, Scher RK, Li S, Xu S, Hsu MC, Guzzo C: Baseline nail disease in patients with moderate to severe psoriasis and response to treatment with infliximab during 1 year. J Am Acad Dermatol 2008;58:224–231.
10.
Tosti A, Piraccini BM, Cameli N, Kokely F, Plozzer C, Cannata GE, Benelli C: Calcipotriol ointment in nail psoriasis: a controlled double-blind comparison with betamethasone dipropionate and salicylic acid. Br J Dermatol 1998;139:655–659.
11.
Piraccini BM, Tosti A, Iorizzo M, Misciali C: Pustular psoriasis of the nails: treatment and long-term follow-up of 46 patients. Br J Dermatol 2001;144:1000–1005.
12.
Rigopoulos D, Ioannides D, Prastitis N, Katsambas A: Nail psoriasis: a combined treatment using calcipotriol cream and clobetasol propionate cream. Acta Dermatol Venereol 2002;82:140.
13.
Luger TA, Cambazard F, Larsen FG, et al: A study of the safety and efficacy of calcipotriol and betamethasone dipropionate scalp formulation in the long-term management of scalp psoriasis. Dermatology 2008;217:321–328.
14.
Augustin M, Peeters P, Radtke M, Moehling U, Lapp C: Cost-effectiveness model of topical treatment of mild to moderate psoriasis vulgaris in Germany: a comparison of calcipotriol/betamethasone (Daivobet/Dovobet/Taclonex) once daily and a morning/evening non-fix combination of calcipotriol and betamethasone. Dermatology 2007;215:219–228.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.