▁the ▁ 2 0 0 3 ▁N AP SI ▁scale ▁and ▁proposed ▁another ▁index ▁which ▁was , ▁like ▁the ▁ 2 0 0 5 ▁article , ▁a ▁modification ▁of ▁the ▁ 2 0 0 3 ▁article , ▁and ▁was ▁named ▁modified ▁N AP SI . ▁A ▁ 2 0 0 8 ▁study ▁found ▁that ▁C ann avo ' s ▁qual itative ▁system ▁correl ated ▁with ▁N AP SI ▁( P < 0 . 0 0 1 ) ▁and ▁is ▁less ▁time - consum ing . ▁ ▁There ▁is ▁a ▁risk ▁of ▁mis di agn osis ▁with ▁on ych omy cos is . ▁ ▁Tre at ment ▁There ▁exist ▁numerous ▁treat ments ▁for ▁n ail ▁ps or ias is ▁but ▁there ▁is ▁little ▁information ▁concerning ▁their ▁effect iveness ▁and ▁safety . ▁Tre at ments ▁include ▁top ical , ▁intr ales ional , ▁radiation , ▁system ic , ▁and ▁combination ▁ther ap ies . ▁ ▁T ac al cit ol ▁o int ment ▁obtain s ▁a ▁significant ▁improvement ▁in ▁all ▁n ail ▁parameters , ▁both ▁of ▁the ▁matrix ▁and ▁of ▁the ▁bed . ▁ ▁C lob et as ol ▁n ail ▁lac quer ▁and ▁t ac al cit ol ▁o int ment ▁▁ 5 - flu or ou rac il . ▁ ▁A ▁reported ▁side - effect ▁is ▁yellow ▁n ails ▁ ▁Cal cip ot ri ol ▁ ▁Cal cip ot ri ol ▁plus ▁bet am eth as one ▁di prop ion ate ▁o int ment . ▁ ▁E fal iz um ab ▁▁ ▁Inf