***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A double-blind , r and omized , vehicle-controlled , parallel-group trial was performed to compare the efficacy and tolerability of tazarotene 0.1 % gel and vehicle gel in 31 patients with fingernail psoriasis . Patients were r and omized to receive tazarotene or vehicle gel , which they applied each evening for up to 24 weeks to 2 target fingernails , one under occlusion and one unoccluded . The tazarotene treatment result ed in a significantly greater reduction in onycholysis in occluded nails ( P < or = .05 at weeks 4 and 12 ) and a significantly greater reduction in onycholysis in nonoccluded nails ( P < or = .05 at week 24 ) . Tazarotene also result ed in a significantly greater reduction in pitting in occluded nails ( P < or = .05 at week 24 ) . There were no other significant between-group differences in pitting , subungual hyperkeratosis , leukonychia , nail plate crumbling/loss , splinter hemorrhage , or nail growth rate .  Tazarotene 0.1 % gel was well tolerated with only 5 of the 21 tazarotene-treated patients reporting a treatment-related adverse event ( all mild or moderate ) . In conclusion , tazarotene 0.1 % gel can significantly reduce onycholysis ( in occluded and nonoccluded nails ) and pitting ( in occluded nails ) and is well tolerated in the treatment of nail psoriasis BACKGROUND Treatment of psoriatic nail is difficult . OBJECTIVE The aim of this study was to evaluate and compare the efficacy and safety of methotrexate and cyclosporine in psoriatic nail . METHODS Thirty-seven psoriatic patients with nail involvement were r and omized to treatment with methotrexate ( initial dose , 15 mg per week ) or cyclosporine ( initial dose , 5 mg per kg of bodyweight per day ) for 24 weeks . The primary outcome was the Nail Psoriasis Severity Index ( NAPSI ) . The Psoriasis Area and Severity Index ( PASI ) , doctor and patient global score were also measured . The scores were determined by a blinded observer . RESULTS Seventeen patients completed the study in each group . The mean percentages of reduction of the NAPSI score after methotrexate and cyclosporine treatments were 43.3 % and 37.2 % , respectively . No significant differences between the treatment groups was found for in the NAPSI , PASI , physician 's and patient 's global score at the end of the study period . The methotrexate group showed a significant improvement in nail matrix scores and the  cyclosporine  group in nail bed score . CONCLUSION Moderate effectiveness on psoriatic nail was found in the two treatment agents and there were no significant differences in efficacy between the groups . A significant improvement was detected in methotrexate group for the nail matrix findings , and in cyclosporine group for the nail bed findings BACKGROUND High-dose cyclosporine therapy significantly alleviates psoriasis within 2 to 4 weeks but is associated with a high rate of side effects . Reports are conflicting on the frequency and promptness of relapse after discontinuation of cyclosporine therapy . OBJECTIVE Our purpose was to compare the efficacy and safety of low-dose cyclosporine with that of etretinate and the stability of remission after replacing cyclosporine therapy with topical anthralin during tapering of cyclosporine . METHODS In a multicenter study 210 patients with moderate to severe chronic plaque-type psoriasis were r and omly assigned to treatment with cyclosporine or etretinate . The initial dosages were 2.5 mg/kg/day for cyclosporine and 0.5 mg/kg/day for etretinate , which could be individually adjusted to 5.0 and 0.75 mg/kg/day , respectively . After a treatment phase of 10 weeks ( phase 1 ) patients receiving cyclosporine were again r and omly assigned to a group in which cyclosporine was replaced by topical dithranol ( anthralin ) , or to another group in which the drug was tapered during the next 12 weeks ( phase 2 ) . All patients treated with etretinate discontinued therapy after 10 weeks and used topical dithranol . RESULTS Mean Psoriasis Area and Severity Index decreased by 71 % in the cyclosporine group and by 47 % in the etretinate group during phase 1 . After 10 weeks of treatment 47 % of the patients treated with cyclosporine and 10 % of those treated with etretinate showed a reduction of more than 80 % in skin involvement . Sixty-four percent of the cyclosporine group and 48 % of the etretinate group did not require an increase in the initial dosage , result ing in a mean daily dose of 3.0 and 0.53 mg/kg , respectively . There was significant alleviation of nail involvement and joint complaints in both groups . In phase 2 the increase in mean Psoriasis Area and Severity Index and the incidence of relapse were significantly higher in patients in whom cyclosporine was discontinued and replaced by dithranol than in patients in whom cyclosporine was tapered or who were pretreated with etretinate . During treatment four patients from the cyclosporine group and three patients of the etretinate group discontinued the study because of side effects . CONCLUSION Low-dose short-term cyclosporine therapy for psoriasis is , in comparison with etretinate , highly effective and well tolerated . Individually adjusted cyclosporine therapy allows the majority of patients to continue the low dosage of 2.5 mg/kg/day and still achieve a good clinical response . Remission can be better preserved by tapering the drug than by discontinuing treatment abruptly Background : Topically applied nail therapeutics need to permeate the nail plate to reach the nail bed or nail matrix and exert their potential beneficial effect at these locations to obtain a therapeutic benefit . So far only topically applied 5-fluorouracil on affected nails of psoriatic patients has been shown to produce a notable clearance . Vehicle formulations enhancing nail permeation processes are thought to increase the concentration of the active agent and therefore therapeutic efficacy , possibly enabling the use of a low concentration of the active agent thereby lowering the incidence of adverse effects . Objective : This study was design ed to verify whether a recently developed nail penetration enhancer in a lotion formulation , Belanyx ® ( urea , propylene glycol ) , improves the efficacy of a low concentration of 5-fluorouracil ( 1 % ) in psoriatic fingernail lesions . Methods : In a r and omised , double-blind , left-right study the efficacy of 1 % 5-fluorouracil in the Belanyx vehicle was compared to the vehicle preparation Belanyx in dystrophic fingernails of 57 psoriatic patients . Both preparations were applied in a once daily regimen for 12 weeks . Responses and adverse effects of one selected target nail were recorded at screening , at baseline and at weeks 2 , 4 , 8 and 12 of treatment with a final assessment at week 16 : 4 weeks after the end of treatment . As parameter of efficacy was chosen the total nail area severity ( NAS ) score , consisting of the separate parameters nail pitting area , number of nail pits , subungual keratosis , onycholysis , oil spots and the various scores of overall improvement . Results : The efficacy of 1 % 5-fluorouracil in lotion and that of the vehicle in suppressing the parameters of dystrophy were shown to be similar at the end of treatment ( p = 0.063 ) or follow-up ( p = 0.130 ) . Both preparations produced statistically significant improvements ( p ≤ 0.05 ) for almost all assessed parameters after 12 weeks of treatment and after the 4 weeks of follow-up . For Belanyx lotion this applied to the nail pitting area , the number of nail pits , subungual keratosis , onycholysis and oil spots . The investigators ’ and patients ’ opinion of overall improvement of severity as well as the total NAS score of one target nail likewise showed a statistically significant improvement at the end of treatment and at the end of the observation period ( p ≤ 0.05 ) . With the 1 % 5-fluorouracil lotion the same statistically significant improvements were obtained in all of the assessed symptoms with the exception of the number of pits and onycholysis at week 12 and week 16 . Possible treatment-related adverse effects were established in 6 patients showing inflammation and infection ( 3 patients ) or discoloration ( 5 patients ) ; 3 patients on 5-fluorouracil lotion  showed onycholysis . Conclusion : Addition of 1 % 5-fluorouracil to the nail permeation enhancer Belanyx does not increase the efficacy of the active agent in psoriatic nail dystrophy of this study population . The obtained results also suggest that Belanyx lotion can be used in this indication since it has shown a favourable efficacy-safety ratio In this double‐blind cross‐over study allopurinol was found to be no more effective than a placebo in the treatment of psoriasis BACKGROUND Tumour necrosis factor alpha ( TNFalpha ) is thought to play a part in the pathogenesis of psoriasis . We assessed the efficacy and safety of continuous treatment with infliximab , a monoclonal antibody that binds to and neutralises the activity of TNFalpha , in patients with psoriasis . METHODS In this phase III , multicentre , double-blind trial , 378 patients with moderate-to-severe plaque psoriasis were allocated in a 4:1 ratio to receive infusions of either infliximab 5 mg/kg or placebo at weeks 0 , 2 , and 6 , then every 8 weeks to week 46 . At week 24 , placebo-treated patients crossed over to infliximab treatment .  Skin and nail signs of psoriasis were assessed using the psoriasis area and severity index ( PASI ) and nail psoriasis severity index ( NAPSI ) , respectively . The primary endpoint , analysed on an intention-to-treat-basis , was the proportion of patients achieving at least a 75 % improvement in PASI from baseline to week 10 . FINDINGS At week 10 , 80 % ( 242/301 ) of patients treated with infliximab achieved at least a 75 % improvement from their baseline PASI ( PASI 75 ) and 57 % ( 172/301 ) achieved at least a 90 % improvement ( PASI 90 ) , compared with 3 % and 1 % in the placebo group , respectively ( p<0.0001 ) . At week 24 , PASI 75 ( 82 % for infliximab vs 4 % for placebo ) and PASI 90 ( 58%vs 1 % ) were maintained ( p<0.0001 ) . At week 50 , 61 % achieved PASI 75 and 45 % achieved PASI 90 in the infliximab group . Infliximab was generally well tolerated in most patients . INTERPRETATION Infliximab is effective in both an induction and maintenance regimen for the treatment of moderate-to-severe psoriasis , with a high percentage of patients achieving sustained PASI 75 and PASI 90 improvement through 1 year While injecting volunteers in Venezuela with a  vaccine for prevention of leishmaniasis , we observed 100 % clinical remission of a psoriatic lesion in one subject . Subsequently , the vaccine ( AS100 ) was evaluated in psoriatic patients with an open label , single center study . The study was conducted in 2,770 subjects and included plaque ( 79 % ) , guttate ( 10 % ) , plaque and guttate ( 10 % ) , palm/plantar , erythrodermia , inverse , plaque and arthritis and nail psoriasis . Baseline PASI compared with post-treatment values were : PASI 100 , 23 % ; PASI 75 , 45 % ; PASI 50 , 13 % ; PASI 10 , 9 % and < PASI 10 , 3 % of patients . Adverse events , attributed to the treatment drug were rated mild or moderate in severity , with none being classified as serious . Subsequently , the results were confirmed in a double-blind , placebo-controlled , parallel group study , of multiple doses of AS100 . In conclusion , AS100 demonstrated a favorable benefit/risk profile and merits further development for the treatment of psoriasis In a double-blind controlled study , superficial radiotherapy ( SRT ) was given to psoriatic fingernails as three fractionated doses of 150 cGy ( 90 kV , 5 mA , 1.00 mm aluminium filter ) . The treated nails demonstrated a significant fall in scoring on a clinical rating scale 10 and 15 weeks after therapy ( mean scores = 4.4 and 4.6 respectively ) when compared with a mean pretreatment score of 5.5 at week 0 ( p less than 0.0001 and p less than 0.05 respectively ) ; the treated nails also showed significant clinical improvement when compared with the sham-treated nails at weeks 10 and 15 ( p less than 0.05 ) . Mean nail thickness in treated nails 15 weeks after therapy was significantly thinner ( mean thickness = 0.75 mm ) than that of sham-treated nails ( 0.88 mm , p = 0.005 ) , but the difference was not significant at week 2 
    Output:
    
Infliximab and golimumab also showed significant results after short-term treatment .
Infliximab , golimumab , SRT , grenz rays , and electron beam caused significant nail improvement compared to the comparative treatment .
Although the quality of trials was generally poor , this review may have some implication s for clinical practice .Although powerful systemic treatments have been shown to be beneficial , they may have serious adverse effects .
The evidence for the use of topical treatments is inconclusive and of poor quality ; however , this does not imply that they do not work .