Department of Pharmaceutics, Krupanidhi College of Pharmacy, Bangalore, Karnataka, India.
Int J Dermatol. 2020 Aug;59(8):915-925. doi: 10.1111/ijd.14840. Epub 2020 Apr 2.
The management of nail psoriasis is an arduous task owing to the disease manifestations and anatomical structure of the nail plate. Although various treatment therapies are available for nail psoriasis, topical therapy is contemplated as one of the most favorable options as systemic therapies are accompanied by numerous side effects that result in patient incompliance. The topical formulations including creams, gels, ointments, and nail lacquers have been used as delivery systems for various antipsoriatic drugs. Among these, nail lacquers emerge to be promising and patient friendly formulations. However, the major defiance with topical delivery is inefficacious penetration of drug through impenetrable keratinized nail plate to reach the target sites: nail matrix and nail bed. Therefore, in order to obtain effectual drug delivery systems that can retain/remain on the nail plate for a prolonged period of time and deliver the drug across it, systematic approaches like quality by design (QbD) need to be followed so that the desired quality can be "built in" the system rather than to rely solely on retrograde evaluation. Furthermore, more advances in research are still required to develop a validated animal model so as to determine the efficacy of the formulation and to establish a mathematical model that can help in predicting the desirable attributes of the formulation and permeation of various molecules through the nail plate.
由于指甲板的疾病表现和解剖结构，指甲银屑病的治疗管理是一项艰巨的任务。虽然有各种治疗方法可用于指甲银屑病，但局部治疗被认为是最有利的选择之一，因为全身治疗会伴随许多副作用，导致患者不配合。包括乳膏、凝胶、软膏和指甲油在内的局部制剂已被用作各种银屑病药物的递送系统。在这些制剂中，指甲油作为一种有前途且对患者友好的制剂脱颖而出。然而，局部递送的主要挑战是药物无法有效地穿透无法穿透的角化指甲板到达靶位：甲母质和甲床。因此，为了获得能够长时间保留/保持在指甲板上并将药物输送穿过指甲板的有效药物递送系统，需要遵循质量源于设计 (QbD) 等系统方法，以便将所需的质量“构建”到系统中，而不是仅仅依靠逆行评估。此外，仍需要更多的研究进展来开发经过验证的动物模型，以确定制剂的疗效，并建立一个数学模型，帮助预测制剂的理想属性和各种分子通过指甲板的渗透。
