Get access

Treatment of severe nail psoriasis with acitretin: an impressive therapeutic result

Authors

  • F. Ricceri,

    1. Division of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, Florence University, Florence, Italy
    Search for more papers by this author
  • L. Pescitelli,

    1. Division of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, Florence University, Florence, Italy
    Search for more papers by this author
  • L. Tripo,

    1. Division of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, Florence University, Florence, Italy
    Search for more papers by this author
  • A. Bassi,

    1. Division of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, Florence University, Florence, Italy
    Search for more papers by this author
  • F. Prignano

    Corresponding author
    • Division of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, Florence University, Florence, Italy
    Search for more papers by this author

  • The present authors declare that they have no competing interests.

Address correspondence and reprint requests to: Francesca Prignano, MD, PhD, Division of Dermatology II, Department of Critical Care Medicine and Surgery, Florence University, Villa S. Chiara, P.za Indipendenza, 50129 Florence, Italy, or email: francesca.prignano@unifi.it.

Abstract

Nail psoriasis is common in adult psoriatic patients. Although several new drugs have recently been introduced for the treatment of skin psoriasis, treatment of nail psoriasis still remains a challenge. Topical treatments (e.g., corticosteroids, tazarotene, 5-fluorouracil, calcipotriol) are the first line in the management of skin psoriasis. The efficacy of these drugs in nail disease, however, is limited, mainly due to the difficulty in penetrating the nail bed and nail matrix. In cases of nail disease resistant to topical treatment, methotrexate, ciclosporin, acitretin, or biological agents can be used. The present authors introduce a 73-year-old patient affected by impressive psoriatic nail disease involving all her fingernails and toenails treated by acitretin, a traditional systemic treatment. After 2 months of treatment there was a marked improvement. The clinical improvement of the nails was progressive and 6 months later it was stable and satisfactory. The remarkable response to treatment in this case suggests that oral acitretin, in association to urea nail lacquer, might be useful in the management of disabling severe nail psoriasis even in absence of severe cutaneous involvement.

Get access to the full text of this article

Ancillary