11 Luglio 2022
I M Abdelmeniem, I M El Eryan, A Nofal, I F Fouda, S S Omar

Topical calcipotriol combined with urea 20% versus intralesional injection of triamcinolone acetonide, 5-fluorouracil, and methotrexate in the treatment of nail psoriasis: A comparative study

Dermatol Ther. 2022 Jun 22;e15660
  • Non esiste un trattamento con efficacia costante per il trattamento della psoriasi ungueale. I trattamenti topici e intralesionali hanno mostrato efficacia e sicurezza promettenti.
  • Secondo questo studio, la combinazione topica di calcipotriolo/urea 20% sembra essere più efficace e sicura per il trattamento della psoriasi ungueale rispetto alle somministrazioni intralesionali di 5-fluorouracile, metotrexato e triamcinolone acetonide.


There is no consistently effective treatment for psoriatic nails. Topical and intralesional modalities have been recently investigated and showed promising efficacy and safety.

To compare the efficacy and safety of intralesional injection of 5-fluorouracil (5-FU), methotrexate (MTX), triamcinolone acetonide (TA) versus topical calcipotriol plus urea 20% in the treatment of nail psoriasis.

This study included 60 patients with nail psoriasis who were randomly assigned to 4 groups, each containing 15 patients. The first 3 groups received intralesional injection of 0.1 ml of 5-FU (group A), MTX (group B), and TA (group C) into the nail matrix and bed monthly for 3 months. Group D received a topical combination of calcipotriol/urea 20% twice daily for 3 months. Therapeutic response was assessed every month for 3 months using the target nail psoriasis severity index (NAPSI).

The mean percentage of improvement was significantly higher in topical calcipotriol/urea combination (57.1 ± 26.4) than intralesional TA (44.2 ± 32.7), intralesional MTX (37.7 ± 14.2), and intralesional 5-FU (29.6 ± 14). Adverse effects were mild and insignificant in the studied groups.

Topical calcipotriol/urea combination seems to be more effective and safe than intralesional injections of 5-FU, MTX and TA. This article is protected by copyright. All rights reserved.

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