Background and Objectives: There are limited treatment options for nail psoriasis. It is important to find new therapies and improve existing ones. The aim of this study was to compare the effectiveness of pulsed dye laser (PDL) versus combined PDL and Nd:YAG lasers in patients with nail psoriasis. Methods: Fourteen patients (with a total of 126 nails affected by nail psoriasis) were treated with PDL (6 J/cm2, 7 mm, 0.45 milliseconds) on both hands and additionally with Nd:YAG (10 J/cm 2 , 6 mm, 15 milliseconds) on the right hand. Three treatment sessions were applied at 4-week intervals and patients were followed up for 6 months after the last session. Disease severity was assessed using the Nail Psoriasis Severity Index, both 8-and 32-point variant. Additionally, Dermatology Life Quality Index was assessed before and after treatment. Results: Overall, there was a statistical difference in 8-and 32-point NAPSI score before and after treatment for both hands. However, there was no statistical difference between the score for the right and left hands based on both scale variants. Some aspects of patients' lives showed improvement due to the treatment. Conclusions: Both PDL in monotherapy and combined Nd:Yag+PDL lasers are safe and effective in treatment of nail psoriasis, although combined therapy shows no advantage over the use of a single laser.

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Treatment of nail psoriasis, a condition that often accompanies cutaneous and arthropatic psoriasis, is a challenge. Symptoms characteristic for the clinical presentation of nail plate are: oil drops, subungual hyperkeratosis, splinter haemorrhages and onycholysis. The most common symptom-pitting-may be observed within the matrix. It is also accompanied by nail crumbling, leukonychia and red spots in the lunula. Pharmacotherapy is often chronic, associated with side effects, and non-effective in many cases. Non-pharmacological treatments involve local effects of UV, IPL or laser beam. The efficacy of these methods is documented. In most cases they are not associated with adverse events encountered in systemic therapies. Treatment efficacy may be assessed using the NAPSI score, which allows monitoring the resolution of lesions during and after conclusion of treatment. stReszczeNie Leczenie łuszczycy paznokci, często towarzyszącej łuszczycy skóry oraz stawowej, stanowi wyzwanie terapeutyczne. Cechy charakterystyczne obrazu klinicznego płytki paznokciowej to plamy olejowe, hiperkeratoza podpaznokciowa, linijne krwawienia oraz onycholiza. W obrębie macierzy można zaobserwować najczęstszy objaw, czyli naparstkowanie, jak również kruchość płytki, leukonychię oraz czerwone plamki w obłączku. Leczenie farmakologiczne jest często przewlekłe, obarczone objawami niepożądanymi i w wielu przypadkach mało skuteczne. Niefarmakologiczne metody terapii obejmują miejscowe stosowanie światła UV, IPL lub wiązki lasera. Są to metody o potwierdzonej w piśmiennictwie skuteczności oraz w większości przypadków pozbawione działań niepożądanych spotykanych w terapiach ogólnych. Do oceny efektów leczenia stosowana jest najczęściej skala NAPSI, która pozwala na śledzenie ustępowania zmian chorobowych w trakcie terapii oraz po jej zakończeniu.