Long-pulsed nd: YAG laser treatment of nail psoriasis: clinical and ultrasonographic assessment.
Humans
Psoriasis
/ diagnostic imaging
Male
Female
Adult
Lasers, Solid-State
/ therapeutic use
Ultrasonography
/ methods
Nail Diseases
/ diagnostic imaging
Middle Aged
Treatment Outcome
Severity of Illness Index
Nails
/ diagnostic imaging
Quality of Life
Pain Measurement
Young Adult
Low-Level Light Therapy
/ methods
Nail psoriasis
Nd:YAG laser
Target NAPSI
Ultrasonography
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
08 Jun 2024
08 Jun 2024
Historique:
received:
11
04
2024
accepted:
26
04
2024
revised:
11
04
2024
medline:
8
6
2024
pubmed:
8
6
2024
entrez:
8
6
2024
Statut:
epublish
Résumé
Nail psoriasis is a chronic, inflammatory condition which is difficult to treat, linked with greater psoriasis severity, and may be associated with anxiety and significant functional impairment of the quality of life. The 1064 nm Nd: YAG laser was reported to yield satisfactory results in the treatment of nail psoriasis.The aim of the study was to assess the clinical and ultrasonographic efficacy of long-pulsed 1064 nm Nd: YAG laser in the treatment of fingernail psoriasis and compare its effect to control fingernails.This intra-patient randomized controlled trial analyzed 86 fingernails collected from 13 patients suffering from cutaneous and nail psoriasis. The nails were randomized into two groups. Group A was treated with Nd: YAG laser once monthly for three sessions while group B served as control. Assessment took place at baseline, 1 and 3 months after the last treatment session. For scoring, the 32-points target NAPSI scoring systems was used. Additionally, two blinded dermatologists' score of improvement, patients' pain assessment by visual analogue score and ultrasonographic assessment were all performed.At the end of follow up, the medians of tNAPSI score, plate definition, matrix thickness, bed thickness and bed vascularity decreased significantly in the Nd: YAG laser treated group in comparison to baseline (p = 0.001, 0.006, 0.039, < 0.001 and 0.010, respectively). While, there was a non-significant reduction in median tNAPSI score in the control group at last follow up, however, ultrasonography recorded a significant reduction in the medians of plate definition, bed thickness and vascularity (p = 0.002, 0.011 and 0.033, respectively) from the baseline. Comparison of the Nd: YAG laser and the control groups showed no significant difference from baseline regarding the medians of tNAPSI, tNAPSI percentile improvement, pits count, blinded evaluation of photographs and ultrasonographic assessments.In conclusion, Nd: YAG laser showed clinical and ultrasonographic improvement in fingernail psoriasis. Ultrasonography is a useful noninvasive tool in diagnosing and monitoring the clinical and even the subclinical changes in nail psoriasis. Nail psoriasis although difficult to treat, may show spontaneous improvement.
Identifiants
pubmed: 38850336
doi: 10.1007/s00403-024-03036-7
pii: 10.1007/s00403-024-03036-7
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
365Informations de copyright
© 2024. The Author(s).
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