Clobetasol for Nail Psoriasis
Title: Treatment of nail psoriasis with 8% clobetasol
nail lacquer: positive experience in 10 patients.
Authors: Sanchez Regana M, et al.
Publication: J Eur Acad Dermatol Venereol. 2005
Sep;19(5):573-7.
Treatment of nail psoriasis is difficult, as several topical
therapies had poor results due to limited drug penetration through
the nail. Recently, a new formulation of 8% clobetasol-17-propionate
in a colorless nail lacquer solution has been shown to be beneficial
in treating nail psoriasis.
The authors wanted to determine the efficacy and safety of 8%
clobetasol-17-propionate drug in nail lacquer solution. To do
this, they enrolled 10 patients with both nail bed and nail matrix
(nail root) psoriasis. These patients were treated with the topical
drug once daily for 21 days and then twice weekly for 9 months.
The authors reported that within 4 weeks of therapy there was
reduction in all symptoms, including nail pain. Response to the
therapy is directly related to the length of treatment –
with longer treatment yielding best results. The authors reported
that nail symptoms that responded well to therapy include:
- Onycholysis or separation or loosening of the nail from its
bed
- Pitting of the nail
- Salmon-colored patches on the nail
- The following nail symptoms had moderate to poor improvements:
- Subungual hyperkeratosis or formation of hard keratinous tissue
under the nail
- Splinter hemorrhages or small areas of bleeding under the
fingernails
The authors noticed that the topical drug was well tolerated
in all of the patients and there were no local (such as tissue
death or atrophy, and infection) or systemic side effects. They
concluded that a formulation containing 8% clobetasol-17-propionate
is a safe, effective, and cosmetically acceptable treatment of
nail bed and nail root psoriasis.
