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Pulsed dye laser may treat nail psoriasis
Pulsed dye laser treatment can safely and effectively treat nail psoriasis at both short- and long-pulse durations, according to recent study results.
In a double blind, intrapatient left-to-right study, researchers randomly assigned 20 patients with bilateral fingernail psoriasis to receive pulsed dye laser (PDL) treatments on proximal or lateral nailfolds, with 40 nails receiving 6-millisecond pulses and 9 J/cm2 and 39 nails receiving 0.45-millisecond pulses and 6 J/cm2 once a month for 6 consecutive months. There was no placebo group. The Nail Psoriasis Severity Index (NAPSI) was used to determine the results of the treatment and whether pulse duration influenced clinical response. Investigators also evaluated adverse events and pain levels experienced by participants.
Within the first three months of treatment, a significant decrease from baseline was observed in the mean total NAPSI and mean nail matrix NAPSI scores of both the short- and long-term pulse groups (P<.005). No significant difference was observed between the effects of the two durations (P>.05). A significant decrease from baseline of mean nail bed NAPSI scores also occurred in both groups (P<.05) during the third and fourth months of treatment, with a significant difference between the durations observed only during the first month.
Adverse events included petechiae in 42.5% of the long-pulse group and 33.3% in the short-pulse group, and hyperpigmentation in 30% of the long-pulse and 28.2% in the short-pulse group. Participants in the long-pulse group reported a higher level of pain, which was considered statistically significant (P<.05). No severe adverse events were reported by either group.
“To our knowledge, this is the first randomized, double blind study of PDL for the treatment of nail psoriasis,” the researchers wrote. “We conclude that PDL is safe, is well-tolerated, and could be considered as an optional treatment.”