Assessment of the efficacy of Betamethasone with Calcipotriol for isolated psoriatic nail affections based on optical coherent tomography

Abstract

Psoriatic nail affection is difficult to diagnose, especially if there are no specific skin changes, and is resistant to traditional treatment methods. The absence of any reliable diagnostics criteria often results in diagnostics errors, inadequate treatment and reduced life quality. Goal. To assess the efficacy of Daivobet for isolated psoriatic nail affections based on optical coherent tomography. Materials and methods. The study involved 10 patients (4 male and 6 female) aged 19—38 (mean age: 27.5 years) including four subjects with isolated psoriatic nail affections (oil spots and dotty cavities on the nail plate) and six subjects with psoriatic nail affections with paronychias (psoriatic plaques and thimble symptom on the nail folds and adjacent skin). The area of the psoriatic affection of the nail plate was 30%—70%. The efficacy of Daivobet and nail condition was clinically monitored by using the optical coherent tomography method and recording the NAPSI index. Tests were performed prior to the treatment and 3 and 6 weeks after the treatment onset. Results. A positive trend with regard to psoriatic paronychia in the form of regressed infiltration was observed against the background of treatment by Week 3 of the treatment, and complete regression of eruptions was observed by Week 6. In all of the subjects, a healthy nail plate grew by 2—3 mm and complete regression of the dotty cavities was observed during Week 6 of the study, which correlated with the reduced PASI index and positive trends based on optical coherent tomography data.