The Comparison of the Efficacy and Safety of Intralesional Triamcinolone Acetonide and Methotrexate Injections for the Treatment of Fingernail Psoriasis
Abstract
Objectives: Studies have demonstrated that the clinical efficacy and remission duration of intralesional corticosteroids in nail psoriasis are highly variable. Moreover, good clinical results have been reported after methotrexate injection in a case study with nail psoriasis. This study aimed to investigate the efficacy and safety of intralesional injection of triamcinolone acetonide and methotrexate in patients with fingernail psoriasis.
Materials and Methods: Thirty-two patients diagnosed with fingernail psoriasis with at least three affected nails were included. Diluted triamcinolone acetonide, methotrexate and serum physiologic solution were randomly injected into three different fingernails having similar nail area psoriasis severity index (NAPSI) scores for four sessions. We compared the signs of nail matrix and nail bed involvement. The severity of fingernail psoriasis was investigated using NAPSI and modified NAPSI.
Results: The responses evaluated by the NAPSI scores were similar in nails treated with methotrexate and triamcinolone acetonide. The improvement of the signs of nail matrix involvement was significantly higher in nails treated with methotrexate, but the improvement of the signs of nail bed involvement was similar in all groups. The improvement of onycholysis was significant only in nails treated with triamcinolone. On the other hand, the improvement of pitting and leukonychia were significant only in nails treated with methotrexate.
Conclusion: Methotrexate injection might be a better treatment choice for fingernail psoriasis with the signs of nail matrix involvement and triamcinolone acetonide injection for the fingernail psoriasis with the signs of nail bed involvement.
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References
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