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Topical Therapy with Oral Systemic Cyclosporin Solution Effective in Psoriatic Nails
A DGReview of :"Treatment of Psoriatic Nails with Topical Cyclosporin: A Prospective, Randomized Placebo-Controlled Study"
Dermatology
03/24/2003
By David Ball
Adults with nail psoriasis can be treated safely and effectively topically with oral systemic cyclosporin (CsA) solution, say Italian researchers.
It is a cosmetically acceptable way to prevent the typical alterations seen in nail psoriasis according to S.P. Cannavò and colleagues at the Institute of Dermatology, University of Messina, Italy.
They suggest that because CsA, a well-established therapy of psoriasis, influences keratinocyte proliferation and T-cell lymphokine release it reduces the cornification of the upper layers of the epidermis. Because of its highly lipophilic nature, however, the topical use of CsA is limited by the difficult penetration of the molecule through the skin and the nail.
In this prospective placebo-controlled study, the investigators used topical oil-dissolved 70% CsA solution to analyse its effectiveness and tolerability in 16 adult patients with nail psoriasis.
Subjects were randomised into two groups of eight: group A was treated with a 70% maize-oil-dissolved oral CsA solution and group B with maize oil alone. The same dermatologists evaluated all patients before starting therapy and after 12 weeks of treatment to compare the therapeutic effectiveness.
Assessments of the severity their nail involvement was made by the subjects at baseline and at the end of the treatment.
Three patients in group A were found to have a complete resolution of nail lesions. A substantial improvement of the overall severity score was seen in the remaining five in this group.
Only one patient in the placebo group B was found to have a slight improvement.
While the treatment results were judged to be positive by all those in group A, a moderate improvement was reported by only one subject in group B.
Dermatology 2003;206:2:153-156.
"Treatment of Psoriatic Nails with Topical Cyclosporin: A Prospective, Randomized Placebo-Controlled Study"
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