title: Efficacy of pulsed dye laser plus topical tazarotene versus topical tazarotene alone in psoriatic nail disease: a single-blind, intrapatient left-to-right controlled study.
abstract: BACKGROUND
  Nail psoriasis is difficult to treat. The efficacy of pulsed dye laser (PDL) therapy for nail psoriasis has been reported in non-placebo controlled studies.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of PDL with topical retinoid in the treatment of nail psoriasis.
  
  
  METHODS
  The study was an intrapatient, left-to-right controlled trial of PDL in 25 patients with recalcitrant, bilateral fingernail psoriasis recruited between February 2011 and August 2011. We included two groups of patients: (1) patients with severe psoriasis who were receiving stable systemic therapy (phototherapy and systemic medication); (2) patients with mild psoriasis who were not receiving systemic therapy. One hand received the experimental treatment (PDL and tazarotene 0.1% cream) and the other, the control treatment (tazarotene 0.1% cream). All five fingernails of the experimental hand were treated with 595-nm PDL once a month for 6 months. Assessments included the modified Nail Psoriasis Severity Index (NAPSI) at baseline, 3, and 6 months, the Physician's Global Assessment at 3 and 6 months, the patient's global assessment, and adverse events.
  
  
  RESULTS
  Nineteen patients completed the 6-month protocol. The mean decrease in modified NAPSI score from baseline to 6 months was significantly more after the experimental treatment than the control treatment. Physician's global assessment showed significantly higher percentage of patients had ≥75% improvement at 6 months in the experimental group than the control group (31.6% vs. 5.3%, P = 0.045). Scores on the patient's global assessment were significantly higher in the experimental group than the control group (P < 0.001).
  
  
  CONCLUSIONS
  PDL plus topical tazarotene 0.1% cream is an effective and safe therapy in the treatment of nail psoriasis.
authors: Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Yu-Chen
authors: YC
authors: Huang
authors: Chia-Lun
authors: CL
authors: Chou
authors: Ying-Yi
authors: YY
authors: Chiang
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000628:therapy*; D009539:Nicotinic Acids / Q000627:therapeutic use*; D011565:Psoriasis / Q000628:therapy*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome; D012176:Retinoids
chemical_list: D003879:Dermatologic Agents; D009539:Nicotinic Acids; C086827:tazarotene; D012176:Retinoids