Therapeutic effects of a 12-week course of alefacept on nail psoriasis.
OBJECTIVE
Nail psoriasis is a common finding in psoriatic patients and it affects the quality of life in a great proportion of patients. Topical or systemic treatments have limited effectiveness or have a serious toxicity potential. Biologicals such as alefacept are the most recent treatment modalities for psoriasis. In the present study we evaluated changes in nail pathology in patients with plaque psoriasis and nail involvement during treatment with alefacept.


METHODS
Digital photographs from eight patients were produced, which were analysed using the nail psoriasis severity index (NAPSI). A minimal NAPSI of 15 was chosen to divide patients into a moderate to very severe nail psoriasis group and a group with no or mild nail psoriasis. A decrease in NAPSI of at least 25% was considered a significant response to therapy.


RESULTS
In the group with at least moderate nail psoriasis, two patients improved, in two patients the nail changes remained unchanged and in one patient the nail pathology was aggravated. The group with no or mild nail psoriasis showed variable results.


CONCLUSIONS
Although alefacept showed some results in treating nail pathology in psoriasis, a more extensive study is required, covering both more patients and a more extensive time period. Furthermore, it would also be clinically relevant to compare the effects of alefacept on nail psoriasis with other biologicals.
Körver
J E M
JE
Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. j.korver@derma.umcn.nl
Langewouters
A M G
AM
Van De Kerkhof
P C M
PC
Pasch
M C
MC
D000328:Adult; D000077944:Alefacept; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000473:pathology*; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D003879:Dermatologic Agents; D011993:Recombinant Fusion Proteins; D000077944:Alefacept