Mokni Sana, Ameur Khaoula, Ghariani Najet, Sriha Badreddine, Belajouza Colandane, Denguezli Mohamed, Nouira Rafiaa
Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia.
Department of Anatomopathology, Farhat Hached University Hospital, Sousse, Tunisia.
Dermatol Ther (Heidelb). 2018 Dec;8(4):647-651. doi: 10.1007/s13555-018-0261-2. Epub 2018 Sep 25.
Psoriasis is a chronic inflammatory disease affecting the skin, nails, and joints. About 61% of psoriatic patients have nail involvement that can cause a significant social problem. Treating nail psoriasis is challenging but can improve the health outcomes and quality of life of patients. Treatment options available for nail psoriasis including topical therapy, intralesional injections, and systemic and biologic agents have various side effects and some benefits. Management is currently inconclusive. Intralesional injection of methotrexate in nail psoriasis was previously documented in few cases. We present a case of nail psoriasis successfully treated with low-dose intralesional methotrexate with no significant side effects in a 48-year-old psoriatic patient. Given the various side effects of conventional topical and systemic therapies limiting their use, we conclude that intralesional methotrexate injection seems to be a safe and effective treatment option for nail psoriasis. However, large controlled studies are needed.
银屑病是一种影响皮肤、指甲和关节的慢性炎症性疾病。约61%的银屑病患者有指甲受累情况，这可能会导致严重的社会问题。治疗指甲银屑病具有挑战性，但可以改善患者的健康状况和生活质量。可用于治疗指甲银屑病的方法包括局部治疗、皮损内注射以及全身用药和生物制剂，这些方法都有各种副作用和一些益处。目前治疗方法尚无定论。以前仅有少数病例记录了皮损内注射甲氨蝶呤治疗指甲银屑病的情况。我们报告一例48岁银屑病患者，采用低剂量皮损内注射甲氨蝶呤成功治疗指甲银屑病，且无明显副作用。鉴于传统局部和全身治疗的各种副作用限制了它们的应用，我们得出结论，皮损内注射甲氨蝶呤似乎是治疗指甲银屑病的一种安全有效的选择。然而，还需要进行大型对照研究。
