Efficacy of pulsed dye laser plus topical tazarotene versus topical tazarotene alone in psoriatic nail disease: a single-blind, intrapatient left-to-right controlled study.

Abstract

BACKGROUND:

Nail psoriasis is difficult to treat. The efficacy of pulsed dye laser (PDL) therapy for nail psoriasis has been reported in non-placebo controlled studies.

OBJECTIVE:

To evaluate the efficacy and safety of PDL with topical retinoid in the treatment of nail psoriasis.

METHODS:

The study was an intrapatient, left-to-right controlled trial of PDL in 25 patients with recalcitrant, bilateral fingernail psoriasis recruited between February 2011 and August 2011. We included two groups of patients: (1) patients with severe psoriasis who were receiving stable systemic therapy (phototherapy and systemic medication); (2) patients with mild psoriasis who were not receiving systemic therapy. One hand received the experimental treatment (PDL and tazarotene 0.1% cream) and the other, the control treatment (tazarotene 0.1% cream). All five fingernails of the experimental hand were treated with 595-nm PDL once a month for 6 months. Assessments included the modified Nail Psoriasis Severity Index (NAPSI) at baseline, 3, and 6 months, the Physician's Global Assessment at 3 and 6 months, the patient's global assessment, and adverse events.

RESULTS:

Nineteen patients completed the 6-month protocol. The mean decrease in modified NAPSI score from baseline to 6 months was significantly more after the experimental treatment than the control treatment. Physician's global assessment showed significantly higher percentage of patients had ≥75% improvement at 6 months in the experimental group than the control group (31.6% vs. 5.3%, P = 0.045). Scores on the patient's global assessment were significantly higher in the experimental group than the control group (P < 0.001).

CONCLUSION:

PDL plus topical tazarotene 0.1% cream is an effective and safe therapy in the treatment of nail psoriasis.

• Authors: Yu-Chen Huang, Chia-Lun Chou, Ying-Yi Chiang
• Journal: Lasers in surgery and medicine (Lasers Surg Med) Vol. 45 Issue 2 Pg. 102-7 (Feb 2013) ISSN: 1096-9101 [Electronic] United States
• PMID: 23423871 (Publication Type: Controlled Clinical Trial, Journal Article)
• Copyright: Copyright © 2013 Wiley Periodicals, Inc.

Chemical References

• Dermatologic Agents
• Nicotinic Acids
• tazarotene

Topics

• Administration, Topical
• Adult
• Aged
• Combined Modality Therapy
• Dermatologic Agents (therapeutic use)
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Humans
• Lasers, Dye (therapeutic use)
• Male
• Middle Aged
• Nail Diseases (therapy)
• Nicotinic Acids (therapeutic use)
• Psoriasis (therapy)
• Severity of Illness Index
• Single-Blind Method
• Treatment Outcome