Low-Dose Acitretin May Reduce Nail Psoriasis

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TUESDAY, March 17 (HealthDay News) -- Low-dose treatment with a drug used to treat skin psoriasis seems to help reduce nail psoriasis, according to Italian researchers.

As many as 78 percent of people with psoriasis have nail psoriasis, which includes irregular pitting, salmon-colored patches on the nail bed, separation of the nail from the nail bed and reddened and often inflamed borders on the nails.

In the study, University of Bologna researchers evaluated the effect of low-dose acitretin therapy (0.2 to 0.3 milligrams per kilogram per day for six months) on the nails of 27 men and nine women, average age 41, with nail psoriasis. They were followed for at least six months after treatment, and the Nail Psoriasis Severity Index (NAPSI) was used to grade the severity of their condition. Higher scores indicate more severe symptoms.

"The mean percentages of reduction of the NAPSI score and modified NAPSI score were 41 percent and 50 percent, respectively," the researchers wrote. "Clinical evaluation at six months showed complete or almost complete clearing of the nail lesions in nine patients (25 percent), moderate improvement in nine (25 percent), mild improvement in 12 (33 percent) and no improvement in six (11 percent)."

They said that just one of the 36 people in the trial experienced any adverse effects on the nail during treatment.

The study appears in the March issue of Archives of Dermatology.

"Although more studies are required to thoroughly assess the effectiveness in larger controlled subject populations, our observations suggest that low-dose systemic acitretin should be considered in the therapeutic armamentarium in the treatment of nail psoriasis," the researchers concluded.

-- Robert Preidt

SOURCE: JAMA/Archives journals, news release, March 16, 2009

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