Comparison of fractional laser‐assisted drug delivery and intralesional injection of triamcinolone acetonide in nail psoriasis

Abstract

Background and objectives: The treatment of nail psoriasis is often unsatisfactory due to poor penetration of topical therapeutics through the nail plate. The development of innovative methods that provide adequate delivery of the drug into the nail is warranted. In this study, we aim to compare the efficacy of intralesional corticosteroid injection versus its topical application after fractional CO 2 laser in the treatment of fingernail psoriasis. Patients and Methods:The study included 36 patients with fingernail psoriasis divided into two groups. The nails in group A were treated with intralesional injection of triamcinolone acetonide while the nails in group B received fractional CO 2 laser therapy followed by topical application of the drug for six sessions. The evaluation was performed using NAPSI and dermatoscopic scores.Results: Both modalities yielded a significant improvement of the nail matrix and bed psoriatic signs. No statistically significant difference was found between the two groups by both clinical and dermatoscopic assessment. The laser treatment was associated with significantly lower pain scores (P = 0.03) and higher patient satisfaction (P = 0.007). Conclusions:Fractional CO 2 laser-assisted delivery of topical corticosteroids can be a potentially effective and well-tolerated therapeutic modality in the treatment of nail psoriasis with comparable efficacy to intralesional injection.

Fractional CO2 Laser versus Fractional CO2 Laser Plus Betamethasone/Calcipotriol Ointment in the Treatment of Nail Psoriasis

“…13 Fractional CO 2 laser-assisted drug delivery of methotrexate or triamcinolone were previously studied versus their intralesional injection for nail psoriasis, and both studies reported significant improvement. 14,15 Moreover, fractional CO 2 laser with tazarotene 0.1% gel showed better NAPSI score improvement after treatment than tazarotene monotherapy. 16…”

“…13 Fractional CO 2 laser-assisted drug delivery of methotrexate or triamcinolone were previously studied versus their intralesional injection for nail psoriasis, and both studies reported significant improvement. 14,15 Moreover, fractional CO 2 laser with tazarotene 0.1% gel showed better NAPSI score improvement after treatment than tazarotene monotherapy. 16 It is essential for appropriate assessment of nail improvement, to allow ample time for the nail plates to grow from the matrix and be visibly appreciable by the observer; thus, our last clinical observation was 9 months after the initial intervention.…”

Aktuelle Entwicklungen und Perspektiven bei Psoriasis

“…2 Seither erschienen in dieser Zeitschrift Publikationen zur Psoriasis in dreistelliger Zahl. In jüngster Zeit umspannen die Themen grundlegende pathophysiologische Aspekte, [3][4][5] therapeutische Ansätze, [6][7][8][9][10][11] epidemiologische Fragen, 12 diagnostische und klinische Entwicklungen, [13][14][15] psychosoziale Aspekte, [16][17][18] bis hin zu Versorgungsforschung und Registerstudien. [19][20][21][22] Empfehlungen zur praktischen Umsetzung neuer Erkenntnisse kulminieren schließlich in Leitlinien.…”

Selection of an Appropriate In Vitro Susceptibility Test for Assessing Anti-Pythium insidiosum Activity of Potassium Iodide, Triamcinolone Acetonide, Dimethyl Sulfoxide, and Ethanol

“…Steroids (i.e., TA, prednisone, and dexamethasone) modulate the immune response, an important property used for controlling many medical conditions, such as allergies, autoimmune diseases, and inflammatory disorders [101][102][103]. Regarding pythiosis treatment, TA has been used as a monotherapy in some affected horses that fully recovered from the disease [68,[79][80][81].…”