Table 1.

Topical therapies for treatment of nail psoriasis.

Author	Year	n	Intervention	Comparison	Treatment protocol	Results	LoE [16]
Nakamura et al. [17]	2012	15	Clobetasol propionate at concentrations 0.05%, 1%, and 8%	Placebo (coat nail lacquer)	Twice weekly, for 4 mos	51% improvement in treatment group (8% clobetasol more efficient)	N/A
Fischer-Levanchini et al. [18]	2012	6	0.1% tazarotene ointment	—	Once daily, under occlusion, for 6 mos	88% improvement in NAPSI scores at 6th mo	N/A
De Simone et al. [19]	2012	21	0.1% tazarotene ointment	No treatment to the other hand	Once daily, to the affected nails of a randomly selected hand, for 3 mos	Statistically significant improvements in the treated hands at week 12	N/A
Tzung et al. [20]	2008	40	0.005% calcipotriol + 0.05% betamethasone dipropionate	0.005% calcipotriol	Calcipotriol twice daily and calcipotriol + betamethasone once daily for 3 mos	Similar efficacy in both groups, significant reduction of NAPSI scores	B
Sánchez-Regaña et al. [21]	2008	15	8% clobetasol in nail lacquer and tacalcitol	—	Clobetasol once daily at weekends and tacalcitol at weekdays under occlusion, for 6 mos	78% reduction in NAPSI at 6 mos	N/A
Rigopoulos et al. [22]	2007	46	0.1% tazarotene cream	0.05% clobetasol propionate	Once daily under occlusion, for 3 mos	Similar efficacy in both groups, significant reduction of NAPSI scores	A2
Regaña et al. [23]	2005	10	8% clobetasol in nail lacquer	—	Once daily, for 3 weeks and twice weekly, for 9 mos	Reduction of all nail alterations within 1 mo	N/A
Cannavò et al. [24]	2003	16	70% CsA oral solution in maize oil	Maize oil	For 3 mos	Complete resolution or substantial improvement in CsA group	A2
Bianchi et al. [25]	2003	25	0.1% tazarotene gel	—	Once daily, for 3 mos	19/25 good clinical response	N/A
Rigopoulos et al. [26]	2002	62	Calcipotriol cream + clobetasol propionate	—	Calcipotriol once daily every weeknight and clobetasol once daily every weekend, for the first 6 mos and twice weekly clobetasol for the 2nd 6 mos	Reduction at subungual hyperkeratosis: 72.3% at 6 mos and 81.2% at 12 mos	N/A
Scher et al. [27]	2001	31	0.1% tazarotene gel	Vehicle gel	Once daily, for 6 mos	Significant improvement of onycholysis and pitting in tazarotene group	A2/B
de Jong et al. [28]	1999	57	1% 5-FU in permeation enhancer lotion (Belanyx)	Belanyx (urea and propylene glycol)	Once daily, for 3 mos	Significant improvements with both preparations	A2
Baran and Tosti [29]	1999	18	8% clobetasol nail lacquer	Placebo	Once daily in the first week, from 2nd week onwards 2-3 times weekly, for up to 9 mos	Clear improvement in 80%, complete resolution in 22% of patients in the treatment arm	B
Tosti et al. [30]	1998	58	Calcipotriol ointment	Betamethasone propionate + salicylic acid	Twice daily, for up to 5 months	Calcipotriol as effective as the combination of topical steroid and salicylic acid (49% versus 51% reduction of subungual hyperkeratosis in fingernails at 6 mos)	B
Yamamoto et al. [31]	1998	20	0.4–2% anthralin in petrolatum	—	Once daily, for 5 mos	Effective in 12/20 patients, particularly in onycholysis and subungual hyperkeratosis	N/A
Fredriksson [32]	1974	20	1% 5-FU solution	—	Twice daily, for up to 6 mos	Considerable improvement in 17/20 patients, 75% reduction of symptoms compared to baseline	N/A

n: number of patients.

mo: month.

N/A: not applicable.

NAPSI: nail psoriasis severity index.

CsA: cyclosporine.

5-FU: 5-fluorouracil.

LoE: level of evidence (A2: randomized, double-blind, controlled trial of good quality, B: randomized controlled trial of poor quality).