TREATMENT OF NAIL PSORIASIS WITH INTRAMATRICIAL METHOTREXATE INJECTIONS

Abstract

Objectives: To evaluate the efficacy and safety of intramatricial Methotrexate injections in treatment of nail psoriasis at the National Hospital of Dermatology and Venereology.

Methods: 30 adult psoriasis patients with nail lesions received an intramatricial injection of 1mg methotrexate (MTX) every 4 weeks for 12 weeks. Nail lesions were assessed by using the Nail Psoriasis Severity Index every 4 weeks and after the whole course of treatment. Adverse effects were aslo noted.

Results: After 12 weeks of treatment, the total NAPSI score of the study group decreased from 39.9±17.7 to 14.3±8.9, equivalent to an improvement of 64.1%, the NAPSI score of each nail decreased from 5.7±1.5 to 2.0±0.8 (64.9%) (p<0.01). 100% of patients have improved in which 86.7% of patients have good or fair improvement. No systemic side effects was reported during 12 weeks of treatment, bleeding around the nail matrix was a rare side effect (6.7%) that did not affect the patient's ability to work and daily activities.

Conclusions: Intramatricial methotrexate injections every 4 weeks for 12 weeks is an effective and safe method in treatment of nail psoriasis.