Nail psoriasis therapy. Review of the literature [Terapia della psoriasi ungueale. Revisione della letteratura]

Incidence of nail involvement in psoriasis ranged, in the literature, from 10 to 55%. Therapy of nail psoriasis is often unsatisfying and great cooperation of patients is required. A great number of topical or systemic chemotherapies are reported in the literature such as: steroids, 5- fluorouracil, calcipotriol, PUVA-therapy, radiotherapy, methotrexate, retinoids, cyclosporin A. Topical steroids, 1% solution of 5-fluorouracil and systemic cyclosporin A, at this moment, seems to be the more effective drugs in nail psoriasis, but side effects are frequent due to their prolonged use in order to reduce relapse. Topical calcipotriol seems to be a promising treatment for subungueal hyperkeratosis and onycholysis especially on account of its high tolerability. Preliminary results about clinical trials of a combination of systemic cyclosporin A and local application of calcipotriol are reported.