Ultrasound Evaluation of the Effectiveness of the Use of Acitretin in the Treatment of Nail Psoriasis

Krajewska–Włodarczyk, Magdalena; Żuber, Zbigniew; Owczarczyk‐Saczonek, Agnieszka

doi:10.3390/jcm10102122

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…In a prospective study on a group of 41 patients with nail psoriasis affecting at least three fingers and a control group, Krajewska-Włodarczyk et al [ 28 ] evaluated the ultrasound changes after treatment with acitretin for 6 months. The nails and the extensor tendon of the fingers were examined with a 24 MHz probe.…”

Section: Evaluation Of the Nail And Enthesis Treatment Responsementioning

confidence: 99%

Nail Ultrasound in Psoriasis and Psoriatic Arthritis—A Narrative Review

et al. 2023

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Ultrasonography has advantages for assessing psoriatic arthritis (PsA) due to its ability to evaluate several targets, including joints, entheses, and tendons, but also skin and nails. Although ultrasound is widely used in PsA, nail ultrasound, despite its potential as a non-invasive method for the early detection of inflammation in the nail apparatus, has low applicability in medical practice, as probes with a higher frequency are needed compared with the frequency of probes usually used. In the present article, we have narratively evaluated the studies published in the last 5 years (19 February 2018–18 February 2023) on nail ultrasound value in the diagnosis and monitoring of PsA. The studies published during this period share common measurement parameters, such as the OMERACT definition of enthesis published in 2018. We included original articles published in PubMed and Web of Science using the following search terms in all possible combinations: psoriatic arthritis, psoriasis, ultrasound, and nail. Articles were declared relevant if they presented data on nail morphology, power Doppler evaluation and nearby structure evaluation, while focusing on digitorum extensor enthesitis. In most of the studies, common morphological parameters were generally increased in patients with psoriasis or PsA and were demonstrated to change with medication. The thickness of the extensor tendon was greater in patients with PsA and psoriasis versus controls and it was correlated with nail clinical changes, especially the presence of onycholysis. The presence of PD showed large variability in healthy individuals. The link between enthesitis and nail involvement is still a subject of controversy, taking into account the latest histological findings. The use of ultrasound in the evaluation of nail and DIP enthesitis remains a challenge and an area of research in the coming years.

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Section: Evaluation Of the Nail And Enthesis Treatment Responsementioning

confidence: 99%

Nail Ultrasound in Psoriasis and Psoriatic Arthritis—A Narrative Review

et al. 2023

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“…One study showed that 6 months of methotrexate therapy was able to reduce nail plate, bed and matrix thickness in patients with psoriatic onychopathy [ 33 ]. A second study revealed a reduction in matrix and nail bed thickness of patients with psoriatic onychopathy treated with acitretin [ 34 ]. There were no data in the literature regarding US monitoring of nail features with a 70 MHz probe in patients treated with mAb.…”

Section: Discussionmentioning

confidence: 99%

Assessment and Monitoring of Nail Psoriasis with Ultra-High Frequency Ultrasound: Preliminary Results

Michelucci,

Dini,

Salvia

et al. 2023

Diagnostics

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Psoriatic onychopathy is one of the clinical presentations of psoriasis and a well-known risk factor for the development of psoriatic arthritis. High-frequency ultrasounds (HFUS > 20 MHz) have recently been used to evaluate the nail apparatus of healthy and psoriatic subjects. The aim of our study was to detect by means of ultra-high-frequency ultrasound (UHFUS 70–100 MHz) alterations of the nail bed and matrix in patients with psoriatic onychopathy and to monitor these parameters during the treatment with monoclonal antibody (mAb). We enrolled 10 patients with psoriatic onychopathy and naive to previous biologic therapies. Patients were evaluated at baseline, after 1 month and after 3 months from the beginning of mAb therapy by a complete clinical assessment and US evaluation. A UHFUS examination with a 70 MHz probe was performed on the thumbnail (I), the index fingernail (II) and the nail with greater clinical impairment (W). The following measurements were analyzed: nail plate thickness (A), nail bed thickness (B), nail insertion length (C), nail matrix length (D) and nail matrix thickness (E). Among the various parameters analyzed, some measures showed a statistically significant decrease with p-value < 0.05 (t0 WA = 0.52 mm vs. t2 WA = 0.42 mm; t0 WB = 2.8 mm vs. t2 WB = 2.4 mm; t0 WE = 0.76 mm vs. t2 WE = 0.64 mm; t0 IIA = 0.49 mm vs. t2 IIA = 0.39 mm). In conclusion, UHFUS could represent a viable imaging technique for the real-time evaluation and monitoring of psoriatic onychopathy, thus supporting the clinical parameters and revealing any subclinical signs of early drug response.

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“…The effectiveness of topical therapy is, however, limited mainly by the very poor permeability of drugs in the nail plate. So far, only a few ungual enhancers, such as N-acetyl cysteine, mercaptoethanol, N-(2-mercaptopropionyl) glycine, have beenidentified [23].…”

Section: Nail Therapymentioning

confidence: 99%

Phonophoresis in Physiotherapy: Mechanisms, Applications, and Emerging Trends for Enhanced Drug Delivery and Therapeutic Efficacy

Bhardwaj,

Chadra Patra,

Potale

et al. 2024

BIO Web Conf.

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Phonophoresis, a widely utilized treatment in physiotherapy, combines topically applied gel or cream-based medications with ultrasonic therapy to enhance percutaneous absorption of pharmacological agents. The procedure employs ultrasound frequencies of 0.7 to 1.1 MHz with intensities ranging from 0.0 to 3.0 Watts per cm². Indications for phonophoresis span various inflammatory, deformative, dermatological, and rheumatic/neurological conditions. Recent studies suggest its clinical efficacy in pain relief and improved function, especially in conditions like lateral epicondylitis and osteoarthritis. The mechanism of action involves both thermal and non-thermal effects, with cavitation playing a key role in enhancing transdermal transport. Phonophoresis offers a non-invasive alternative for drug delivery, bypassing hepatic metabolism and minimizing systemic side effects. Various medicinal gels, particularly diclofenac, are used for transdermal drug delivery through phonophoresis. Low frequency phonophoresis has gained attention for enhancing transdermal transport, especially for macromolecules. Its applications extend beyond physiotherapy to include ocular drug delivery, nail therapy, gene therapy, and sports sciences. Clinical studies demonstrate the effectiveness of phonophoresis in conditions like anterior knee pain, tuberculous lymphadenitis, acute low back pain, and latent myofascial trigger points. Dosage considerations emphasize optimizing thermal effects without causing tissue damage. Studies highlight the potential of phonophoresis in relieving pain and improving function, particularly in knee osteoarthritis. Additionally, phonophoresis with Phyllanthus amarus nanoparticle gel shows promise in reducing pain and enhancing functional capacity in symptomatic knee osteoarthritis. In summary, phonophoresis stands as a valuable modality in physiotherapy, showcasing diverse applications and demonstrating clinical efficacy in various musculoskeletal and inflammatory conditions. Further research is warranted to explore its full potential and optimize treatment protocols.

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Ultrasound Evaluation of the Effectiveness of the Use of Acitretin in the Treatment of Nail Psoriasis

Cited by 7 publications

References 33 publications

Nail Ultrasound in Psoriasis and Psoriatic Arthritis—A Narrative Review

Nail Ultrasound in Psoriasis and Psoriatic Arthritis—A Narrative Review

Assessment and Monitoring of Nail Psoriasis with Ultra-High Frequency Ultrasound: Preliminary Results

Phonophoresis in Physiotherapy: Mechanisms, Applications, and Emerging Trends for Enhanced Drug Delivery and Therapeutic Efficacy

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