Intralesional Injection for Inflammatory Nail Diseases

Clark, Ashlynne H.; Jellinek, Nathaniel J.

doi:10.1097/dss.0000000000000621

Cited by 15 publications

(17 citation statements)

References 5 publications

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“…While adverse events [35][36][37] , including atrophy, are possible, there is strong consensus that they are minimal or even non-existent when this technique is used with appropriate training 38 . Hematomas and transient numbness of the distal digit are, instead, more frequent.…”

Section: Discussionmentioning

confidence: 99%

Isolated nail lichen planus: An expert consensus on treatment of the classical form

Iorizzo

Tosti

Starace

et al. 2020

Journal of the American Academy of Dermatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Isolated nail lichen planus: An expert consensus on treatment of the classical form

Iorizzo

Tosti

Starace

et al. 2020

Journal of the American Academy of Dermatology

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“…In these patients, intralesional steroid injections of proximal nail fold and matrix area represent the treatment of choice. 5,14,15 Treatment with intralesional triamcinolone acetonide injections is commonly performed in many nail inflammatory diseases, such as nail lichen planus, nail psoriasis, and trachyonychia and chronic paronychia. 16 Different procedures can be chosen based on disease severity and localization within the nail apparatus, and there is not a The principle limit of our study is the lack of a matched control group.…”

Section: Discussionmentioning

confidence: 99%

“…We called this new stage “intermediate retronychia” (Figure 3). In these patients, intralesional steroid injections of proximal nail fold and matrix area represent the treatment of choice 5,14,15 …”

Section: Discussionmentioning

confidence: 99%

Intralesional steroid treatment for the intermediate stage of retronychia: A pilot study

Alessandrini

Sechi

Merli

et al. 2020

Dermatologic Therapy

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Retronychia describes the proximal ingrowing of the nail plate. In the early stage, topical steroids are the gold standard therapy, while in the late stage surgical treatment is mandatory. We identified an intermediate severity stage of retronychia, where the topical treatment alone is ineffective and surgery is avoidable. Intralesional steroids turn the best treatment in these patients. A pilot study consisting of a 3-month treatment period and 9-month follow-up time was designed to evaluate the treatment outcome to intralesional steroid injections in patients affected by the intermediate-stage of toenail retronychia. The complete recovery of retronychia-associated nail abnormalities was observed in 27/28 recruited patients at the end of the treatment phase. Paronychia, nail plate discoloration, proximal nail fold (PNF) elevation, and discharge were reduced (P < .01) after one steroid administration, while nail regrowth became significant after two sessions. No significant difference in terms of clinical outcome was found, while pain VAS score and intra-operative pain evaluated with Wong-Baker faces scale were higher in the female group (P < .01). Limitation Lack of control group of patients. Despite its temporary effect, the intralesional triamcinolone injection is an effective, cheap, and safe treatment especially for the intermediate stage of retronychia.

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“…One of the conventional treatments for onychodystrophy is a TA ILI. However, this does not have a prescribed regimen so far, and its efficacy is inconsistent 23,24 . The extent of inflammation in the NM is thought to contribute to the dystrophic changes of the NPs.…”

Section: Discussionmentioning

confidence: 99%

“…Patient satisfaction score inconsistent. 23,24 The extent of inflammation in the NM is thought to contribute to the dystrophic changes of the NPs. Therefore, use of TA ILI in onychodystrophy associated with such dystrophic changes by virtue of its unique anatomy supports this hypothesis.…”

Section: F I G U R Ementioning

confidence: 99%

Treatment of idiopathic onychodystrophy with a 1064 nm picosecond neodymium‐doped:yttrium aluminum garnet laser: A retrospective study

Lee

Kim

et al. 2020

J of Cosmetic Dermatology

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Background Laser treatment has emerged as a novel treatment modality for onychodystrophy. Only a few small series have assessed the efficacy of laser treatment in onychodystrophy, most of which were case reports. The therapeutic effect of the 1064 nm neodymium‐doped:yttrium aluminum garnet (Nd:YAG) laser for onychodystrophy has been demonstrated. Recently, the picosecond Nd:YAG (PSNY) laser has been introduced to improve various skin disorders. Aims The aim of this study was to verify the efficacy of a 1064 nm PSNY in management of idiopathic onychodystrophy. Methods We present a case series of dystrophic nails treated with a PSNY for onychodystrophy improvement. Planimetry using ImageJ software was used to calculate lesion reduction and proximal clear nail growth. Clinical improvement was assessed using a 5‐point Global Assessment Scale (GAS). Adverse events were also assessed. Results Twenty‐five patients (11 males and 14 females) with a total of 128 nails (94 finger nails and 34 toe nails) were treated. The mean treatment number was 8.7 ± 6.2, and the mean total duration of treatment was 33.4 ± 34.6 weeks. The average proportion of the lesion area decreased significantly (from 65.9% to 46.6%) after PSNY treatment (P < .001). The mean GAS (3.16 ± 1.18) exhibited fair improvement, and there were no serious adverse events. Conclusion The 1064 nm PSNY laser can provide fair improvement for onychodystrophy with a good prognosis at least during the follow‐up period and optimal cosmetic results in Asian patients.

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Intralesional Injection for Inflammatory Nail Diseases

Cited by 15 publications

References 5 publications

Isolated nail lichen planus: An expert consensus on treatment of the classical form

Isolated nail lichen planus: An expert consensus on treatment of the classical form

Intralesional steroid treatment for the intermediate stage of retronychia: A pilot study

Treatment of idiopathic onychodystrophy with a 1064 nm picosecond neodymium‐doped:yttrium aluminum garnet laser: A retrospective study

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