Background: Treatment of nail psoriasis is difficult. Several topical therapies have been employed with poor results because drug penetration is limited in this localization. Recently, a new formulation containing 8% ...Background: Treatment of nail psoriasis is difficult. Several topical therapies have been employed with poor results because drug penetration is limited in this localization. Recently, a new formulation containing 8% clobetasol- 17-propionate in a colourless nail lacquer vehicle has shown good results in the control of nail psoriasis. Objective: To determine the efficacy and safety of 8% clobetasol- 17-propionate in a lacquer vehicle in nail psoriasis. Methods: Ten patients with both nail bed and matrix psoriasis were included in the study. They were treated with a colourless nail lacquer containing 8% clobetasol- 17-propionate that was applied once daily for 21 days and then twice weekly for 9 months. Results: Within 4 weeks of therapy there was a reduction of all the nail alterations, including nail pain. Therapeutic response was directly related to the length of therapy. The nail parameters that responded best to therapy were onycholysis, pitting and salmon patches. Subungual hyperkeratosis and splinter haemorrhages on the other hand had moderate and poor improvement, respectively. The treatment was well tolerated in all of the patients and there were no local (i.e. atrophy and sobreinfection) or systemic secondary effects. Conclusions: The formulation containing 8% clobetasol- 17-propionate is a safe, effective and cosmetically highly acceptable treatment for nail bed and matrix psoriasis.展开更多
Background: Involvement of the nail is quite common in psoriasis and at times may be the sole diagnostic clue. However, the histopathology of nail psoriasis has not been adequately evaluated. A confirmation of the dia...Background: Involvement of the nail is quite common in psoriasis and at times may be the sole diagnostic clue. However, the histopathology of nail psoriasis has not been adequately evaluated. A confirmation of the diagnosis is required in cases suspected to have nail psoriasis in order to plan longterm therapy. Objectives: To assess the diagnostic significance and safety profile of nail biopsy in cases with nail psoriasis. Methods: Clinical and mycological features were studied in 42 patients with nail psoriasis. Of these, 22 patients gave consent for nail biopsies to be taken and the histopathological changes were assessed. Results: Males were affected more commonly (57% ) with a peak incidence in the age group of 10- 20 years (29% ). Distal onycholysis, discoloration of nail plate, subungual hyperkeratosis and fine nail pitting were the predominant clinical features. In the 22 biopsies done, hyperkeratosis with parakeratosis (91% ) was found to be the most common and hypergranulosis was the least common histological finding (36% ). Clinicohistological correlation was possible only in 55% cases. Periodic acid-Schiff (PAS) stainingwas done for all biopsies. Conclusions: Histopathological examination of nails is a valuable diagnostic aid, especially in the absence of skin lesions. Examination of the PAS-stained sections is necessary before making a histological diagnosis of nail psoriasis because onychomycosis and psoriasis may show similar histology.展开更多
文摘Background: Treatment of nail psoriasis is difficult. Several topical therapies have been employed with poor results because drug penetration is limited in this localization. Recently, a new formulation containing 8% clobetasol- 17-propionate in a colourless nail lacquer vehicle has shown good results in the control of nail psoriasis. Objective: To determine the efficacy and safety of 8% clobetasol- 17-propionate in a lacquer vehicle in nail psoriasis. Methods: Ten patients with both nail bed and matrix psoriasis were included in the study. They were treated with a colourless nail lacquer containing 8% clobetasol- 17-propionate that was applied once daily for 21 days and then twice weekly for 9 months. Results: Within 4 weeks of therapy there was a reduction of all the nail alterations, including nail pain. Therapeutic response was directly related to the length of therapy. The nail parameters that responded best to therapy were onycholysis, pitting and salmon patches. Subungual hyperkeratosis and splinter haemorrhages on the other hand had moderate and poor improvement, respectively. The treatment was well tolerated in all of the patients and there were no local (i.e. atrophy and sobreinfection) or systemic secondary effects. Conclusions: The formulation containing 8% clobetasol- 17-propionate is a safe, effective and cosmetically highly acceptable treatment for nail bed and matrix psoriasis.
文摘Background: Involvement of the nail is quite common in psoriasis and at times may be the sole diagnostic clue. However, the histopathology of nail psoriasis has not been adequately evaluated. A confirmation of the diagnosis is required in cases suspected to have nail psoriasis in order to plan longterm therapy. Objectives: To assess the diagnostic significance and safety profile of nail biopsy in cases with nail psoriasis. Methods: Clinical and mycological features were studied in 42 patients with nail psoriasis. Of these, 22 patients gave consent for nail biopsies to be taken and the histopathological changes were assessed. Results: Males were affected more commonly (57% ) with a peak incidence in the age group of 10- 20 years (29% ). Distal onycholysis, discoloration of nail plate, subungual hyperkeratosis and fine nail pitting were the predominant clinical features. In the 22 biopsies done, hyperkeratosis with parakeratosis (91% ) was found to be the most common and hypergranulosis was the least common histological finding (36% ). Clinicohistological correlation was possible only in 55% cases. Periodic acid-Schiff (PAS) stainingwas done for all biopsies. Conclusions: Histopathological examination of nails is a valuable diagnostic aid, especially in the absence of skin lesions. Examination of the PAS-stained sections is necessary before making a histological diagnosis of nail psoriasis because onychomycosis and psoriasis may show similar histology.
