Original Article Treatment of nail psoriasis with Pulse Dye Laser plus calcipotriol betametasona gel vs. Nd:YAG plus calcipotriol betamethasone gel: An intrapatient left-to-right controlled study Tratamiento de psoriasis ungueal con Pulse dye laser frente a Nd: YAG, en asociación con gel de betametasona: un estudio con control intrapaciente izquierda-derecha
To compare the efficacy, adverse reactions and tolerability of treatment of nail psoriasis with PDL vs. Nd:YAG, in association with betametasona calcipotriol gel.
An open, prospective intrapatient left-to-right study was designed. The right hand of each patient received treatment with PDL and the left hand with Nd:YAG. Betamethasone calcipotriol gel was applied once a day during the first week after each laser session. A total of four sessions were administered.
Improvement In Nail Psoriasis After The Fourth Injection Of...
< 0.000). There was neither statistical difference between the reduction in nail bed and matrix NAPSI nor in the treatment with PDL vs. Nd:YAG. The administration of Nd:YAG was more painful. No serious adverse effects were documented.
PDL and Nd:YAG have proven to be an effective treatment for nail psoriasis with no serious adverse effect. No statistically significant difference was found between the two treatments.
Comparar la eficacia, las reacciones adversas y la tolerabilidad del tratamiento de la psoriasis ungueal con PDL vs. Nd: YAG en asociación con gel de betametasona calcipotriol.
Dealing With Nail Psoriasis? Here's How You Can Treat It
Estudio prospectivo abierto con control intrapaciente izquierda-derecha. La mano derecha de cada paciente recibió tratamiento con PDL y la mano izquierda con Nd: YAG. Se aplicó gel de betametasona calcipotriol una vez al dÃa durante la primera semana después de cada sesión de láser en las 2 manos. Se administraron un total de 4 sesiones.
La eficacia clÃnica se evaluó de acuerdo con la escala NAPSI. Todos los pacientes mostraron una mejorÃa en las lesiones del lecho y de la matriz ungueal. La media global del NAPSI disminuyó en 15, 46 (p < 0, 000). No hubo diferencia significativa entre la mejorÃa de las lesiones del lecho y la matriz ni en el tratamiento con el PDL vs. Nd: YAG. La administración de Nd: YAG fue más dolorosa. No se documentaron efectos adversos graves.
PDL y Nd: YAG han demostrado ser tratamientos eficaces para la psoriasis ungueal sin documentarse efectos adversos graves. No se encontró diferencia estadÃstica significativa entre los 2 tratamientos.All authors are with the Dermatology Unit, Medical Applications at the Laser National institute of Laser Enhanced Sciences, at Cairo University in Cairo , Egypt. Ms. Aal is also with the Cairo Hospital for Dermatology and Venereology in Cairo, Egypt.
Efficacy Of Combined Fractional Carbon Dioxide Laser And Topical Tazarotene In Nail Psoriasis Treatment: A Randomized Intrapatient Left‐to‐right Study
We sought to compare the efficacy of ILIS to PDL for the treatment of psoriatic fingernails using a dermoscope in the assessment and follow-up.
This study included 30 patients with bilateral nail psoriasis. The fingernails of one hand were treated with PDL, whereas ILIS was used to treat the fingernails of the other hand. One psoriatic nail was left alone as a control. Every patient received four treatment sessions once every month. Efficacy was recorded clinically using the Nail Psoriasis Severity Index (NAPSI) and by a dermoscope before treatment (baseline) and at eight, 24, and 36 weeks after treatment.
The assessment by NAPSI revealed improvements of 22.24% and 24.11% occurred in the laser group and the intralesional steroid group, respectively. Also, the dermoscopic assessments revealed an improvement of 18.33% in the laser group versus that of 21.69% in the ILES. No significant difference was found between the two groups.
Nail Psoriasis Treated With Pulse Dye Laser Al Mutairi A, Elkashlan M
Both PDL and ILIS are considered safe treatments for nail psoriasis, yielding nearly equal results. The dermoscope is a reliable tool for the diagnosis and follow-up of nail psoriasis treatment.
Pitting, onycholysis, and salmon-colored patches on the nail bed are the main signs of nail psoriasis. Other signs may be seen, such as splinter hemorrhages, nail bed hyperkeratosis, nail thickening and crumbling, paronychia, leukonychia, trachyonychia, and erythema of the lanula.
There is no standardized regimen for the treatment of nail psoriasis, and the choice of therapy depends on the patient’s history, clinical manifestations, and concomitant diseases.
Nail Psoriasis: Treatment Options And Management Strategies In Special Patient Populations
The success of topical therapy (e.g., steroid, tazarotene, 5-fluorouracil, calcipotriol) is limited by the difficulty in achieving adequate antipsoriatic concentrations at the inflammatory sites.
On the other hand, systemic therapy (e.g., methotrexate, cyclosporine, and retinoids) has moderate efficacy, infrequent complete clearance, and a declining effect over time.
In the past few years, pulsed-dye laser (PDL) therapy has been used for treating psoriasis because of the highly vascular nature of psoriatic lesions. Aside from the destruction of blood vessels, PDL can reduce the number of helper T-cells in the dermis and cytotoxic T-cells in the epidermis and normalize epidermal proliferation and abnormal keratinization.
Nail Psoriasis Vs. Fungus: Symptoms, Causes, Treatment
Found that onycholysis and subungual hyperkeratosis demonstrated the earliest response to treatment. Meanwhile, to assess the efficacy of using different pulse durations, Treewittayapoom et al
Compared the efficacy of different pulse durations of PDL in the treatment of nail psoriasis where they stated that there was a significant reduction in the Nail Psoriasis Severity Index (NAPSI) score in both groups. Intralesional corticosteroid injection (ILIS) is considered to be a standard treatment for nail psoriasis.
Dermoscopy is considered a good tool for detecting signs of nail psoriasis and can help with the early detection of nail affection.
The Efficacy Of 308nm Laser Treatment Of Psoriasis Compared To Historical Controls
The first goal of this work was to compare the therapeutic effect of PDL versus that of ILIS in the treatment of nail psoriasis. The second one was to assess the role of dermoscopy in the diagnosis of nail psoriasis and in the follow-up of the outcomes.
This randomized, intrapatient comparative, controlled study was approved by the National institute of Laser Enhanced Sciences ethical board, and informed written consent forms were signed by the included patients. The study was also conducted according to the Declaration of Helsinki.
Thirty patients were enrolled in this study. Patients who participated had bilateral nail psoriasis affecting at least three nails and no history of previous topical systemic therapy for psoriasis or ILIS treatment within the previous two months. Patients were excluded from the study for any of the following reasons: younger than 12 years of age, pregnancy, and presence of onychomycosis (excluded by KOH and dermoscopy).
Psoriasis Vulgaris Laser Treatment At Aura Skin Institute Chandigarh India
Treatment protocol. The psoriatic nails of one hand were treated by PDL and the fingernails of the other hand were treated by ILIS. Four treatment sessions were applied at four-week intervals. One nail was left as a control nail on each hand. Randomization was completed via the envelope method. The psoriatic nails were divided into three groups as follows:
In Group 1 (treated by PDL), the psoriatic nails were treated with 585-nm PDL on the proximal and lateral nail folds (Cynergy; Cynosure, Westford, MA, USA). The fluence used ranged from 8.0 to 10.0 J/cm
In Group 2 (treated by ILIS), in this group, the psoriatic nails were treated with ILIS by TAC in a concentration of 5 mg/mL. Specifically, they were injected using a needle-free device (MadaJet; Mada Medical, Carlstadt, NJ, USA) in the proximal and distal nail folds with 1 cm between every two injection sites.
Light Therapy For Psoriasis: Types, Home Therapy, And More
Evaluation methods. The total NAPSI score was identified and recorded for each nail, both clinically and by dermoscopy, before treatment (baseline) and at eight, 24, and 36 weeks after the start of treatment.
NAPSI was used to evaluate the psoriatic findings in the nail before treatment, after treatment, and during follow-up, with a score assigned to each nail for both the nail bed and nail matrix psoriasis. The nail plate was divided into four quadrants by imaginary longitudinal and horizontal lines. Nail matrix psoriasis was assessed for by the presence of nail pitting, leukonychia, red spots in the lanula, and crumbling in each quadrant of the nail. Nail bed psoriasis was assessed for by the presence of onycholysis, oil drop (salmon patch) dyschromia, splinter hemorrhages, and nail bed hyperkeratosis in each quadrant of the nail. If the score was 0, this meant that no findings of interest were present; conversely, A score of 1 denoted that findings were present in one quadrant of the nail, a score of 2 meant that findings were present in two quadrants of a nail, and so forth. Thus, each nail had a matrix score of 0 to 4 and a nail bedscore of 0 to 4, with a total nail score that was the sum of the nail bedand nail matrix scores (0–8 points). The sum of the total score of all involved fingernails is the total NAPSI score for that patient at that time.
Clinical evaluation. All fingernails were photographed using a Samsung Galaxy Note 2 (Samsung, Suwon-si, Korea) camera with eight megapixels and a resolution of 3, 264 × 2, 448 pixels.
Psoriasis Treatment — Hunter Coast Dermatology & Laser
Dermoscopic evaluation. A dermoscopic evaluation of the nail bedand matrix psoriasis signs was completed for each nail before treatment, after treatment, and during follow-up (Dermlite 3Gen; Dermlite, San Juan Capistrano, CA, USA) with a magnification of 10×.
Patient satisfaction. Patients were asked to rate their satisfaction with each treatment modality as satisfied, partially satisfied, or not satisfied. They were asked to report any side effect.
![PDF] Pulsed Dye Laser For The Treatment Of Nail Psoriasis. - Laser Treatment For Nail Psoriasis](https://i1.wp.com/d3i71xaburhd42.cloudfront.net/f9461dfdea047a451d09a7804da3bb39c50b4430/2-Figure1-1.png?strip=all "PDF] Pulsed Dye Laser For The Treatment Of Nail Psoriasis.")
Statistical analysis. Data were summarized and analyzed using the Statistical Package for the Social Sciences version 17 (IBM Corporation, Armonk, NY, USA), Microsoft Excel 2013 (Microsoft Corp., Redmond, WA, USA), and Medcalc version 15.8 (MedCalc Software, Flanders, Belgium). Data distribution was assessed for normality by using
0 comments
Post a Comment