Johnston Leah A, Poelman Susan M
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
SAGE Open Med Case Rep. 2024 Oct 22;12:2050313X241289594. doi: 10.1177/2050313X241289594. eCollection 2024.
Nail psoriasis occurs in approximately half of all cases of plaque psoriasis and manifests with onychodystrophy, which includes morphological features of onycholysis, subungual hyperkeratosis, oil drop sign, pitting, splinter hemorrhages, leukonychia, and crumbling of the nails. Nail psoriasis can have a significant adverse impact on quality of life. However, nail psoriasis is often refractory to both local and systemic therapies, making it challenging to treat. Topical and oral phosphodiesterase-4 inhibitors have been successfully used to treat multiple different subtypes of psoriasis. Topical roflumilast, a phosphodiesterase-4 inhibitor cream, has recently received United States Food and Drug Administration and Health Canada approval for the treatment of plaque psoriasis. In this case report, a 25-year-old female with a 20-year history of nail psoriasis achieved complete resolution of her onychodystrophy after 5 months of daily application of topical roflumilast, without experiencing any side effects. This case report suggests that topical roflumilast may be a useful and well-tolerated therapy for psoriatic nails.
约半数斑块状银屑病患者会出现甲银屑病，表现为甲营养不良，包括甲剥离、甲下过度角化、油滴征、点状凹陷、裂片形出血、白甲以及指甲破碎等形态学特征。甲银屑病会对生活质量产生重大不利影响。然而，甲银屑病通常对局部和全身治疗均难起效，治疗颇具挑战性。局部和口服磷酸二酯酶-4抑制剂已成功用于治疗多种不同亚型的银屑病。局部用罗氟司特，一种磷酸二酯酶-4抑制剂乳膏，最近已获得美国食品药品监督管理局和加拿大卫生部批准用于治疗斑块状银屑病。在本病例报告中，一名有20年甲银屑病病史的25岁女性，在每日外用罗氟司特5个月后，甲营养不良完全消退，且未出现任何副作用。本病例报告提示，局部用罗氟司特可能是一种治疗银屑病甲的有效且耐受性良好的疗法。
