A simplified protocol of steroid injection for psoriatic nail dystrophy

Berker, Dilek; Lawrence, C.M.

doi:10.1046/j.1365-2133.1998.02031.x

Cited by 89 publications

(96 citation statements)

References 22 publications

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“…Encouraging results have been reported with topical and intralesional steroids when the matrix is affected [6], while cyclosporine solution is more effective in cases of nail bed psoriasis [7]. Topical tazarotene has been reported to be effective in ameliorating both matrix and nail bed signs [8].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Nail Psoriasis with a Two-Compound Formulation of Calcipotriol plus Betamethasone Dipropionate Ointment

Rigopoulos¹,

Gregoriou²,

Daniel

et al. 2009

Dermatology

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Background: Treatment of nail psoriasis remains a challenge. Objective: To evaluate the efficacy of a two-compound product of calcipotriol plus betamethasone dipropionate ointment on nail psoriasis in an open-label study. Methods: Twenty-five psoriatic patients with nail involvement and mild cutaneous psoriasis were instructed to apply a calcipotriol-betamethasone valerate ointment formulation once daily for 12 weeks on affected nails. Outcome measures were assessed at baseline and at weeks 4, 8 and 12 using the nail psoriasis severity index (NAPSI). Results: Twenty-two patients having 114 nails involved at baseline with a mean NAPSI of 5.8 ± 1.7 were followed up for 12 weeks. The mean NAPSI at the end of the treatment period was reduced to 1.6 ± 0.6 presenting a 72% improvement. Significant improvement was observed for hyperkeratosis and onycholysis (reduction of mean hyperkeratosis NAPSI from 2.2 ± 0.5 to 0.5 ± 0.1 and mean onycholysis NAPSI from 2.0 ± 0.6 to 0.4 ± 0.2), moderate improvement for oil drops (reduction of mean oil drop NAPSI from 1.2 ± 0.4 to 0.8 ± 0.3) and slight improvement for pitting (reduction of mean pitting NAPSI from 0.8 ± 0.2 to 0.6 ± 0.2). Conclusions: The calcipotriol plus betamethasone dipropionate two-compound ointment, applied once daily for 12 weeks, was shown to improve nail psoriasis.

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Section: Discussionmentioning

confidence: 99%

Treatment of Nail Psoriasis with a Two-Compound Formulation of Calcipotriol plus Betamethasone Dipropionate Ointment

Rigopoulos¹,

Gregoriou²,

Daniel

et al. 2009

Dermatology

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Section: Conventional Treatment Approaches To Managing Nail Psoriasismentioning

confidence: 99%

“…The therapy consists of injecting small doses of corticosteroid directly into or near the structure of the nail unit that is responsible for the specific nail dystrophy [25,26,27,28,29]. Although evidence is limited, intralesional injections appear to be particularly effective for alleviating lesions caused by psoriasis of the nail matrix, including certain nail plate abnormalities, such as pitting and ridging [1].…”

Section: Conventional Treatment Approaches To Managing Nail Psoriasismentioning

confidence: 99%

“…De Berker and Lawrence conducted an open trial of intralesional steroid injections (triamcinolone 10 mg/ml) in 19 patients with nail psoriasis [25]. Onycholysis was improved in 50% of nails, pitting in 45%, transverse ridging in 93%, thickening in 83% and subungual hyperkeratosis in 100% [25]. However, complete resolution did not occur in all clinical manifestations, with only 20% of nails with pitting and only 25% with subungual hyperkeratosis reaching complete clearance [25].…”

Section: Conventional Treatment Approaches To Managing Nail Psoriasismentioning

confidence: 99%

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Treatment and Management of Psoriasis with Nail Involvement: A Focus on Biologic Therapy

Langley

Daudén

2010

Dermatology

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Nail involvement in psoriasis is typically overlooked, although it can affect up to 50% of patients with psoriasis and cause functional impact as well as psychological stress that can significantly affect quality of life. In addition, psoriatic patients with nail disease tend to have a more severe skin condition, a higher rate of unremitting and progressive arthritis and more associated anxiety and depression. Historically, the treatment of nail psoriasis has proven difficult, with most patients feeling that the treatment for their nail disease was unsatisfactory. The current management of nail psoriasis includes topical, intralesional and systemic therapies, although little clinical evidence is available on the effectiveness of conventional treatments and, consequently, no specific treatment approach has been fully supported. Biologic agents are beginning to emerge as a viable option to treat patients with both cutaneous and nail clinical manifestations of psoriasis and psoriatic arthritis. The extra disease burden that nail symptoms place on the patient can be considered indicative of a more severe form of the disease and should be taken into consideration when assessing treatment options.

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“…Intraläsionale Injektion von Glukokortikoiden direkt in die für die Nagelverän-derungen verantwortliche Nagelstruktur oder deren Umgebung ist eine weitere Therapieoption der Nagelpsoriasis [4,27]. Im Rahmen einer offenen Studie mit 1-maliger Injektion (ggf.…”

Section: Intraläsionale Und Lasertherapieunclassified

„Stiefkind“ Nagelpsoriasis

2012

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Approximately 50% of all patients with psoriasis develop characteristic nail changes as a clinical correlate of psoriatic inflammation of the nail matrix and/or nail bed. The most frequent signs of nail psoriasis are pitting and distal onycholysis. The most commonly used score to assess the severity of nail involvement at present is the Nail Psoriasis Severity Index (NAPSI). Although more than half of affected patients experience a significant physical and mental impairment, this index does not include patient-reported symptoms. There is a striking association between nail psoriasis and a higher risk of psoriatic arthritis with a prevalence of nail involvement among patients with psoriatic arthritis as high as 70%. A possible explanation is the close anatomical link between the nail apparatus and the distal interphalangeal joint; enthesitis of the latter is carried by fibers to the nail and becomes clinically visible as nail psoriasis. Nail involvement is not adequately reflected in current concepts of disease management. There is limited evidence for the efficacy of topical therapies in nail psoriasis. A number of large studies document an improvement of nail psoriasis in response to biologics and, more recently, also to methotrexate.

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A simplified protocol of steroid injection for psoriatic nail dystrophy

Cited by 89 publications

References 22 publications

Treatment of Nail Psoriasis with a Two-Compound Formulation of Calcipotriol plus Betamethasone Dipropionate Ointment

Treatment of Nail Psoriasis with a Two-Compound Formulation of Calcipotriol plus Betamethasone Dipropionate Ointment

Treatment and Management of Psoriasis with Nail Involvement: A Focus on Biologic Therapy

„Stiefkind“ Nagelpsoriasis

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