Psoriasis and Lichen Planus of Nails

Gerstein, William

doi:10.1001/archderm.1962.01590100033009

Cited by 27 publications

(33 citation statements)

References 3 publications

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“…A few studies showed that topical treatment and oral psoralen plus ultraviolet A phototherapy were effective on onycholysis and pitting [12]. Superficial radiotherapy was tested on 10 patients and was shown to be effective for a short time [13]. Grenz ray and electron beam therapy has also provided temporary relief.…”

Section: Discussionmentioning

confidence: 99%

Nail Psoriasis Successfully Treated with Intralesional Methotrexate: Case Report

Sarıcaoğlu

Turan³

2011

Dermatology

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Psoriasis is a common, chronic disease which affects nearly 3% of the population. The lifetime incidence of nail involvement increases up to 80–90% for psoriatic patients. Nail psoriasis is considered a significant social problem. Many topical agents have been used for psoriatic nails with various side effects and some benefits; management is currently inconclusive. Methotrexate (MTX) is a folic acid analog, which irreversibly binds to dehydrofolate reductase and blocks deoxyribonucleic acid synthesis. It is considered a potential treatment option for rapidly growing cells and has an anti-inflammatory effect through inhibition of the polyamine pathway in autoimmune diseases. Intralesional MTX has been used successfully for various indications. We present a case successfully treated with low-dose intralesional MTX with no observed side effects in a 26-year-old female psoriatic patient suffering from nail dystrophy. In contrast, conventional topical and systemic therapies have various side effects, which limit their use. We conclude that intralesional MTX injection seems to be a safe and effective treatment option for nail psoriasis; however, large controlled studies are needed.

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Section: Discussionmentioning

confidence: 99%

Nail Psoriasis Successfully Treated with Intralesional Methotrexate: Case Report

Sarıcaoğlu

Turan³

2011

Dermatology

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“…In order to reach the nail matrix, the PNF is a popular site of injection, because it lies directly over the proximal matrix. The most frequently used steroid appears to be triamcinolone acetonide, which has been 99,100 The frequency of injections is also variable, ranging from one study that only administered one corticosteroid injection 100 to investigations that gave weekly or monthly injections for various lengths of time. 96,98 Other sources have recommended injections to be administered every 3 to 4 weeks for a total of 4 to 6 injections, 11 or monthly injections for the first 6 months with 4 injections over the next 6 months and then every 2 months for the following 6-to 12-month timeframe.…”

Section: Intralesional Therapymentioning

confidence: 99%

“…Before treatment, a preliminary digital anesthetic block has also been used. 99,100 Amongst the studies, a range between 0.1 to 0.3 mL per nail injection has been used. Subsequent injections might be required; however, this would depend on the severity and rate of recurrence of the psoriasis.…”

Section: Intralesional Therapymentioning

confidence: 99%

“…10,99 Furthermore, some patients experienced short-term paresthesia. 99,100 The chronic nature of the disease often requires repeated courses of the steroid, which can lead to reversible atrophy at the injection site 98,99 and potential atrophy of the underlying terminal phalanx, a condition known as ''disappearing digit.'' [57][58][59] Other complications, such as collagen atrophy and rupture of the extensor tendon, are only theoretical possibilities, because there are no well-documented cases of these events.…”

Section: Intralesional Therapymentioning

confidence: 99%

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Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

Jiaravuthisan

Sasseville

Vender

et al. 2007

Journal of the American Academy of Dermatology

368

382

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“…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%

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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Psoriasis and Lichen Planus of Nails

Cited by 27 publications

References 3 publications

Nail Psoriasis Successfully Treated with Intralesional Methotrexate: Case Report

Nail Psoriasis Successfully Treated with Intralesional Methotrexate: Case Report

Psoriasis of the nail: Anatomy, pathology, clinical presentation, and a review of the literature on therapy

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

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