title: A Review of Indigo Naturalis as an Alternative Treatment for Nail Psoriasis.
abstract: BACKGROUND
  Nail psoriasis is challenging to treat. The few currently available therapies are limited in efficacy, and often produce unfavorable side effects. A plant extract widely used in Traditional Chinese Medicine, indigo naturalis (Qing Dai), is presented in this review as an alternative topical treatment for skin and nail psoriasis. The purpose of this article is to present information on a viable alternative treatment with a favorable side effect profile for a difficult disease to treat.
  
  
  METHODS
  A PubMed search for the term "indigo naturalis" was performed, and literature from 2006 to the present relevant to indigo naturalis and treatment of psoriasis and nail psoriasis was reviewed.
  
  
  RESULTS
  Indigo naturalis shares several therapeutic mechanisms with current psoriasis treatments, such as regulation of keratinocyte proliferation and differentiation, restoration of epidermal barrier function, and reduction of inflammatory processes. Clinically, it is well tolerated.
  
  
  CONCLUSIONS
  Recent research of indigo naturalis suggests that it is a safe, inexpensive, and effective alternative topical treatment for skin and nail psoriasis.
authors.forename: Laura
authors.initials: L
authors.lastname: McDermott
authors.forename: Raman
authors.initials: R
authors.lastname: Madan
authors.forename: Reena
authors.initials: R
authors.lastname: Rupani
authors.forename: Daniel
authors.initials: D
authors.lastname: Siegel
mesh_terms: D000287:Administration, Topical; D049109:Cell Proliferation / Q000187:drug effects; D016207:Cytokines / Q000187:drug effects / Q000378:metabolism; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D004817:Epidermis / Q000187:drug effects; D006801:Humans; D029883:Indigofera; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use; D015603:Keratinocytes / Q000187:drug effects; D009260:Nail Diseases / Q000188:drug therapy*; D009821:Oils / Q000009:adverse effects / Q000627:therapeutic use; D009824:Ointments / Q000009:adverse effects / Q000627:therapeutic use; D008517:Phytotherapy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D011565:Psoriasis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D015398:Signal Transduction / Q000187:drug effects; D012867:Skin / Q000187:drug effects; D016896:Treatment Outcome; D019010:Vascular Cell Adhesion Molecule-1 / Q000187:drug effects / Q000378:metabolism
chemical_list: D016207:Cytokines; D004365:Drugs, Chinese Herbal; D007211:Indoles; D009821:Oils; D009824:Ointments; D019010:Vascular Cell Adhesion Molecule-1; C530990:Qingdai compound; C027185:indirubin