Treatment of nail psoriasis with topical application of clobetasol propionate 0.05% solution: a pilot study

Abstracts: BACKGROUND: Nail psoriasis affects 50% of patients with skin disease and may occur in the absence of skin lesions. The course is typically chronic, with fingernails affected more commonly than toenails. For this reasons, impairment of cosmetic appearance and of fingernail function are typical complains. Treatment of psoriasis limited to the nails is not standardized, as it depends on severity of nail changes and number of nail affected. Topical therapies include drugs vehicled in creams and ointments that are often scarcely liked by patients, resulting in poor compliance and low efficacy. OBJECTIVE: The aim of our study was to evaluate the efficacy, tolerability and patient’s compliance of topical therapy with clobetasol propionate 0,05% vehicled in a solution in nail psoriasis. METHODS: 15 patients (8 females and 7 males aged 18-50 years), affected by isolated nail psoriasis of 1 to 3 digits, were prescribed topical therapy with clobetasol propionate lotion to be applied on the affected nail once a day for 4-6 months. 8 patients presented nail bed psoriasis with onycholysis and subungual hyperkeratosis, while 7 patients had also signs of matrix disease. Periodic evaluation (every 2 months) of treatment efficacy was performed by iconography. At the end of the treatment period, efficacy was evaluated also by the experimenter and by the patient, who also gave his/her opinion about tolerability and easiness of application. RESUTS: All patients concluded the study, with marked improvement of the nail signs seen in 10 patients and complete resolution in 5. Nail bed disease responded better than matrix diseases, as expected. No side effects were recorded. All patients judged the treatment easy to apply and effective. CONCLUSIONS: The lotion composed by clobetasol propionate 0,05% is an effective and safe option for topical therapy of nail psoriasis.