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Tosti A, Ricotti C, Romanelli P, Cameli N, Piraccini BM. Evaluation of the Efficacy of Acitretin Therapy for Nail Psoriasis. Arch Dermatol. 2009;145(3):269–271. doi:10.1001/archdermatol.2008.600
To evaluate the therapeutic efficacy of acitretin in patients with isolated nail psoriasis.
Open study involving 36 patients with moderate to severe nail psoriasis treated with acitretin.
University-based outpatient dermatology clinic specializing in nail diseases.
A total of 27 men and 9 women (mean age, 41 years) with nail psoriasis.
Therapy consisted of acitretin, 0.2 to 0.3 mg/kg/d, for 6 months.
Main Outcome Measures
Clinical evaluation, and Nail Psoriasis Severity Index (NAPSI) and modified NAPSI scores before therapy, every 2 months during therapy, and 6 months after treatment.
The mean percentage of reduction of the NAPSI score after treatment was 41%; the mean percentage of reduction of the modified NAPSI score of the target nail was 50%. Clinical evaluation at 6 months showed complete or almost complete clearing of the nail lesions in 9 patients (25%), moderate improvement in 9 (25%), mild improvement in 12 (33%), and no improvement in 6 (11%).
Results from low-dose acitretin therapy show NAPSI score reductions comparable with those studies evaluating biologic drugs for nail psoriasis and suggest that low-dose systemic acitretin should be considered in the treatment of nail psoriasis.
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