Evaluation of the efficacy of acitretin therapy for nail psoriasis.
OBJECTIVE
To evaluate the therapeutic efficacy of acitretin in patients with isolated nail psoriasis.


METHODS
Open study involving 36 patients with moderate to severe nail psoriasis treated with acitretin.


METHODS
University-based outpatient dermatology clinic specializing in nail diseases.


METHODS
A total of 27 men and 9 women (mean age, 41 years) with nail psoriasis.


METHODS
Therapy consisted of acitretin, 0.2 to 0.3 mg/kg/d, for 6 months.


METHODS
Clinical evaluation, and Nail Psoriasis Severity Index (NAPSI) and modified NAPSI scores before therapy, every 2 months during therapy, and 6 months after treatment.


RESULTS
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%).


CONCLUSIONS
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.
Tosti
Antonella
A
Department of Dermatology, University of Bologna, Via Massarenti 1, 40138 Bologna, Italy. antonella.tosti@unibo.it
Ricotti
Carlos
C
Romanelli
Paolo
P
Cameli
Norma
N
Piraccini
Bianca Maria
BM
D017255:Acitretin / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000188:drug therapy*; D011565:Psoriasis / Q000188:drug therapy*
D007641:Keratolytic Agents; D017255:Acitretin