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To the Editor.—
In a letter to the editor in the August Archives (1982;118:535-536), Lindskov reported the nail findings in a patient receiving the aromatic retinoid etretinate for psoriasis. We report our results with retinoid treatment in two patients who had generalized psoriasis with prominent nail involvement.
Report of Cases.—Case 1.—
A 46-year-old man had extensive plaque-type psoriasis and the following nail changes: pitting, onycholysis, crumbling of the nail plate, proximal nail-fold involvement, and oil-drop change (Fig 1). The patient was receiving 0.5 to 1 mg/kg/day of oral etretinate. In terms of nail involvement, excellent improvement was noted in the crumbling of the nail plate and oil-drop change, and the onycholysis was responding well. Psoriatic involvement of the proximal nail fold improved moderately, and a fair response in the pitting was noted (Fig 2). The systemic side effects of the experimental drug included cheilitis, hair loss, itching, dryness,