A randomized comparison of efficacy and safety of intralesional triamcinolone injection and clobetasol propionate ointment for psoriatic nails
Einapak Boontaveeyuwat, Narumol Silpa-Archa, Nasuda Danchaivijitr, Chanisada Wongpraparut*
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Email: ctuchinda@yahoo.com
Background: Even though the traditional therapy for nail psoriasis has been used for decades, no randomized, controlled trial of such treatment has been conducted to date.
Objective: To evaluate the efficacy and safety of intralesional triamcinolone injections compared with 0.05% clobetasol ointment for psoriatic nails.
Materials and methods: Psoriasis patients, each with three fingernails with similar degrees of severity, were randomly recruited for intralesional triamcinolone injection group, 0.05% clobetasol ointment group, and a control group. The target Nail Psoriasis Severity Index (NAPSI) score of each finger was evaluated, any adverse effects were recorded, and photographs were taken.
Results: Forty-eight affected nails were analyzed. At the second month, a significantly greater reduction of the target NAPSI score was observed in the injection group compared to the control group (p = .003). There was a greatest reduction of the score in the following two month-period, which showed significant difference from the topical group (p = .003) and the control group (p = < .001). The score of the injection group, however, subsequently rose at the six-month visit so that there was no longer any statistically-significant difference between the three groups.
Conclusions: In spite of its temporary effect, the intralesional triamcinolone injection is an effective and safe treatment for psoriatic nails.
The Journal of Dermatological Treatment ปี 2561, May ปีที่: ฉบับที่ หน้า 1-6
Intralesional Triamcinolone injection, Psoriasis, psoriatic nails, clobetasol propionate ointment