Rahimnia Amirhossein, Ehsani Amirhoushang, Esmaeili Nafiseh, Aryanian Zeinab, Razavi Zahra, Koohian Mohammadabadi Mina, Ehsani Ala
Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Lasers Med Sci. 2025 Apr 21;16:e9. doi: 10.34172/jlms.2025.09. eCollection 2025.
Nail psoriasis poses a notable challenge due to its significant impact on patient's quality of life and its resistance to traditional treatments. Recent interest has focused on laser therapies, which offer targeted treatment by addressing the underlying inflammatory processes of the disease. This study evaluated the effectiveness and safety of pulsed dye laser (PDL), fractional CO2 laser, and Nd:YAG (neodymium-doped yttrium aluminum garnet) laser for nail psoriasis. In this randomized clinical trial, 40 patients with mild to moderate bilateral nail psoriasis were enrolled at Razi hospital. The participants were divided into four groups: Nd:YAG laser, PDL, fractional CO2 laser, and a control group treated with calcipotriol/betamethasone ointment. Each received four treatment sessions over four months. The Nail Psoriasis Severity Index (NAPSI) was used to evaluate effectiveness, while pain and satisfaction were assessed using the visual analog scale (VAS). Statistical significance was determined, with P<0.05 as the threshold. The study found that PDL achieved the highest reduction in NAPSI scores, with a significant 62.4% decrease, followed by a 54.6% decrease with the fractional CO2 laser. In contrast, the Nd:YAG laser achieved a less notable 32.4% improvement, while the ointment control group showed a 15.9% decrease. Pain was least reported in the PDL group, and satisfaction scores were highest among these patients. The PDL and fractional CO2 lasers outperformed both the Nd:YAG laser and the topical therapy in effectiveness and patient comfort. PDL and fractional CO2 laser treatments are superior interventions for managing nail psoriasis, providing a significant improvement in NAPSI scores and better patient experiences compared to the Nd:YAG laser and topical ointment. These findings endorse the inclusion of laser therapy in management plans for nail psoriasis, suggesting further research into optimizing their use and potential combination with other therapies. https://irct.behdasht.gov.ir/; identifier: IRCT20220723055530N4.
甲银屑病因其对患者生活质量的重大影响以及对传统治疗的耐药性而构成显著挑战。最近的研究兴趣集中在激光疗法上，该疗法通过解决疾病的潜在炎症过程提供靶向治疗。本研究评估了脉冲染料激光（PDL）、二氧化碳点阵激光和Nd:YAG（掺钕钇铝石榴石）激光治疗甲银屑病的有效性和安全性。在这项随机临床试验中，40例轻至中度双侧甲银屑病患者在拉齐医院入组。参与者被分为四组：Nd:YAG激光组、PDL组、二氧化碳点阵激光组和接受卡泊三醇/倍他米松软膏治疗的对照组。每组在四个月内接受四个疗程的治疗。使用甲银屑病严重程度指数（NAPSI）评估有效性，同时使用视觉模拟量表（VAS）评估疼痛和满意度。以P<0.05为阈值确定统计学显著性。研究发现，PDL使NAPSI评分降低幅度最大，显著降低了62.4%，其次是二氧化碳点阵激光降低了54.6%。相比之下，Nd:YAG激光改善幅度较小，为32.4%，而软膏对照组降低了15.9%。PDL组报告的疼痛最少，这些患者的满意度得分最高。PDL和二氧化碳点阵激光在有效性和患者舒适度方面均优于Nd:YAG激光和局部治疗。PDL和二氧化碳点阵激光治疗是治疗甲银屑病的更佳干预措施，与Nd:YAG激光和外用软膏相比，NAPSI评分有显著改善，患者体验更好。这些发现支持将激光治疗纳入甲银屑病的管理计划，建议进一步研究优化其使用以及与其他疗法的潜在联合使用。https://irct.behdasht.gov.ir/；标识符：IRCT20220723055530N4。
