Treatment of Nail Psoriasis with a Two-Compound Formulation of Calcipotriol plus Betamethasone Dipropionate Ointment

Abstract

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.

The human nail – Barrier characterisation and permeation enhancement

“…The gel was well tolerated. Nail psoriasis was also improved following topical application of calcipotriol and betamethasone dipropionate ointment applied once daily for 12 weeks (Rigopoulos et al, 2009).…”

Detailed Analysis of Specific Nail Psoriasis Features and Their Correlations with Clinical Parameters: A Cross-Sectional Study

“…Dermatologists should be trained to use nail psoriasis assessment scores, as the choice of treatment is strongly related to the clinical features of nail psoriasis and the patient’s specific factors [15]. …”

Marked Improvement in Nail Psoriasis during Treatment with Adalimumab

“…Topical treatments including topical steroids, vitamin D derivates, topical cyclosporine, 5-fluorouracil and anthralin are frequently ineffective, and application remains difficult. Nevertheless, topical agents are often prescribed in patients with limited nail involvement, and a recent paper has indeed shown nail psoriasis improvement under calcipotriol plus betamethasone dipropionate two-compound ointment [4]. Although traditional systemic agents such as methotrexate, cyclosporine and acitretin can also be relatively effective, their use is limited by a serious toxicity potential [5,6].…”