THE EFFECTIVENESS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE IN THE TREATMENT OF PSORIATIC NAIL LESIONS

Huyền Trần Thị, Phương Phạm Thị Minh, Thiện Nguyễn Ngọc

Main Article Content

Abstract

Nail lesions in psoriasis are quite common, occurring in 50-80% of cases, causing loss of aesthetics, pain and limited mobility. This study was conducted to evaluate the effectiveness of intralesional triamcinolone acetonide in psoriatic nail lesions. This was a clinical intervention study, without a control group, conducted on 11 patients with a total of 79 damaged nails, injected with 10mg/ml triamcinolone acetonide at 4 locations around the nail, each location from 0.02-0.1ml; repeated injection after the first treatment 2 months. The results showed that the number of pitted nails and the number of subungual hyperkeratotic nails at the 2nd and 4th months were lower than those before treatment with p<0.05. The number of nails with horizontal grooves, rough nails, white nail lines, oil drop signs, onycholysis and Splinter hemorrhages did not differ from before treatment. NAPSI (Nail Psoriasis Severity Index) before treatment was 32.4±14.0; it decreased to 27.3±9.0 after 2 months; to 25.8±7.2 after 4 months (p<0.001); N-NAIL (Nijmegen Nail Psoriasis Activity Index) score before treatment was 55.6±27.8; it decreased to 47.3±20.6 after 2 months; to 42.0±16.5 after 4 months (p<0.001). Side effects included cutaneous atrophy and telangiectasia (both in 2 patients, accounting for 18.2%). One-third of female patients (33.3%) had menstrual disorders. 

Article Details

References

1. Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and metabolic syndrome: a systematic review and meta-analysis of observational studies. J Am Acad Dermatol. 2013;68(4):654-662. doi:10. 1016/j.jaad.2012.08.015
2. de Jong EM, Seegers BA, Gulinck MK, Boezeman JB, van de Kerkhof PC. Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients. Dermatol Basel Switz. 1996;193(4):300-303. doi:10.1159/000246274
3. Boontaveeyuwat E, Silpa-Archa N, Danchaivijitr N, Wongpraparut C. A randomized comparison of efficacy and safety of intralesional triamcinolone injection and clobetasol propionate ointment for psoriatic nails. J Dermatol Treat. 2019;30(2): 117-122. doi:10.1080/ 09546634.2018.1476647
4. Khoo BP, Giam YC. A pilot study on the role of intralesional triamcinolone acetonide in the treatment of pitted nails in children. Singapore Med J. 2000;41(2):66-68.
5. Klaassen KMG, van de Kerkhof PCM, Bastiaens MT, Plusjé LGJM, Baran RL, Pasch MC. Scoring nail psoriasis. J Am Acad Dermatol. 2014;70(6): 1061-1066. doi:10.1016/j.jaad. 2014.02.010
6. Saleem K, Azim W. Treatment of nail psoriasis with a modified regimen of steroid injections. J Coll Physicians Surg--Pak JCPSP. 2008;18(2):78-81.
7. Pelin Üstüner AB. The Comparison of the Efficacy and Safety of Intralesional Triamcinolone Acetonide and Methotrexate Injections for the Treatment of Fingernail Psoriasis. doi:10.4274/ atfm.43534
8. Nantel-Battista M, Richer V, Marcil I, Benohanian A. Treatment of nail psoriasis with intralesional triamcinolone acetonide using a needle-free jet injector: a prospective trial. J Cutan Med Surg. 2014;18(1):38-42. doi:10.2310/ 7750.2013.13078