Role of nail bed methotrexate injections in isolated nail psoriasis: conventional drug via an unconventional route. (1st June 2017)

• Record Type: Journal Article
• Authors: Grover, C.; Daulatabad, D.; Singal, A.
• Is Part Of: Clinical and experimental dermatology. Volume 42:Number 4(2017)
• Page Start: 420
• Page End: 423
• Publication Date: 2017-06-01
• Subjects: Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/ced.13087
• Languages: English
• ISSNs: 0307-6938

Abstract

Summary: Nail psoriasis can be a debilitating condition; however, in patients with isolated nail involvement, the use of toxic systemic therapies such as methotrexate may not be justified. We report on 4 patients (30 involved nails between them), who were treated with injections of methotrexate (0.1 mL of a 25 mg/mL solution) into the nail bed at 3‐weekly intervals. Mean baseline Nail Psoriasis Severity Index (NAPSI) was 4.77 (range 2–8, cumulative score 143; n = 30); dropping successively at each visit to 2.43 (range 0–4, cumulative score 73; n = 30) at 15 weeks. The decline in mean NAPSI from 4.87 to 2.17 was statistically significant ( P < 0.001; Friedman analysis). Reported adverse effects were pain, injection site pigmentation and nail bed haemorrhage. Administration of specific targeted therapy to the nail bed may help manage nail psoriasis effectively.