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.
CorrespondenceEfficacy and safety of tacrolimus ointment 0AE1% vs. betamethasone 17-valerate 0AE1% in the treatment of chronic paronychia: an unblinded randomized study
Onychomatricoma is a rare benign fibroepithelial filamentous tumor originating from the nail matrix. It typically presents with the clinical tetrad of xanthonychia, pachyonychia, proximal splinter hemorrhages and increased transverse overcurvature of the nail plate. The giant variant can easily confuse the clinician due to its extensive nail dystrophy that can mask the characteristic features of this tumor. Benign (fibrokeratoma, ungual fibroma, onycholytic matricoma) and malignant entities (Bowen's disease, squamous cell carcinoma, onycholytic carcinoma) are mimics of the disease. Nail surgery can facilitate the diagnosis, which should always be confirmed by histology, as rare variants do exist.
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