Calcipotriene/Betamethasone Dipropionate Foam as a Potential Safe and Effective Treatment of Nail Psoriasis

Background: Nail psoriasis is a common condition that affects quality of life in individuals with psoriasis and psoriatic arthritis. Topical treatments have been shown to be effective in treating nail bed disease but not as effective in treating nail matrix diseases, which often requires intralesional corticosteroids. Objectives: The objective of this open-label study was to evaluate the efficacy of combination calcipotriol/betamethasone dipropionate foam as a treatment for nail psoriasis including nail matrix disease. Method: We report three patients with moderate to severe nail psoriasis with involvement of all ten fingernails who applied study foam nightly for 6 months. Nails were assessed using the NAPSI score evaluating both nail bed and nail matrix disease. Results: NAPSI score improved including nail matrix disease in the majority of nails. No skin irritation or unexpected adverse events occurred. Conclusions: We conclude this foam combination product could be an effective and safe treatment for fingernail psoriasis and may provide better nail matrix penetration as evidenced by improvement in nail matrix score. Further studies are needed for additional evaluation.