Nail psoriasis: An updated review of clinical reports on therapy and formulation aspects for topical delivery

The treatment of the psoriatic nails is strenuous and systemic therapies are associated with various side effects that lead to patient incompliance. Topical therapy seems to be mainstay approach that limits side effects and is patient compliant. The topical formulations include creams, gels, and ointments and nail lacquers. Of these nail lacquers appear to be promising, patient friendly formulation. However, the major challenge through topical route is inefficient permeation of drug through dense keratinized nail plate to reach target sites: nail matrix and nail bed. Chemical and physical enhancement techniques can be used for enhancing the drug permeation through nail plate. There has been quite a lot of research in this field in recent times. The current review focuses on various clinical reports on systemic, topical and peripheral therapies (intralesional, phototherapy and laser). It primarily focuses on topical nail lacquer formulation wherein an attempt has been made to summarize the factors affecting permeation of drug across the nail plate. Further, physical and chemical modes for permeation enhancement have been described. Finally the medicated nail lacquers as an effective and novel drug delivery system for treating nail psoriasis has been reviewed.

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