ISSN: 1859 - 2872
Nail psoriasis treated with oral methotrexate: A two-year follow-up case report
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Abstract
Nail involvement in psoriasis has received increasing attention because of its substantial impact on cosmetic appearance and quality of life, while treatment remains challenging due to the limited efficacy of topical therapies, the potential toxicity of systemic agents and the high cost of biologics. We report a case of a 38-year-old man with psoriasis predominantly affecting the fingernails, who was treated with oral methotrexate (MTX) and followed continuously for two years. During treatment, nail lesions showed marked improvement as assessed by the Nail Psoriasis Severity Index (NAPSI), with a favorable safety profile; however, relapse occurred after treatment discontinuation. This case suggests that oral MTX represents a feasible and cost-effective option for nail psoriasis in clinical practice and highlights the importance of long-term follow-up and maintenance strategies to minimize recurrence.
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References
2. Kaeley GS, Eder L, Aydin SZ, Rich P, Bakewell CJ (2021) Nail Psoriasis: Diagnosis, Assessment, Treatment Options, and Unmet Clinical Needs. J Rheumatol 48(8): 1208-1220. doi:10.3899/jrheum.201471
3. Battista T, Scalvenzi M, Martora F, Potestio L, Megna M (2023) Nail Psoriasis: An Updated Review of Currently Available Systemic Treatments. Clin Cosmet Investig Dermatol 16: 1899-1932. doi:10.2147/CCID.S417679
4. Gümüşel M, Özdemir M, Mevlitoğlu I, Bodur S (2011) Evaluation of the efficacy of methotrexate and cyclosporine therapies on psoriatic nails: a one-blind, randomized study. J Eur Acad Dermatol Venereol 25(9):1080-1084. doi:10.1111/j.1468-3083.2010.03927.x
5. Grynszpan R, Barreiros G, do Nascimento Paixão M, et al (2021) Coexistence of onychomycosis and nail psoriasis and its correlation with systemic treatment. Mycoses 64(9): 1092-1097. doi:10.1111/myc.13331
6. Grover C, Reddy BSN, Uma Chaturvedi K (2005) Diagnosis of nail psoriasis: Importance of biopsy and histopathology. Br J Dermatol 153(6): 1153-1158. doi:10.1111/j.1365-2133.2005.06862.x
7. Bertanha L, Damas II, Stelini RF, Cintra ML, Di Chiacchio N (2024) Role of tangential biopsy in the diagnosis of nail psoriasis. An Bras Dermatol 99(5): 696-705. doi:10.1016/j.abd.2023.11.005
8. Hadeler E, Mosca M, Hong J, Brownstone N, Bhutani T, Liao W (2021) Nail Psoriasis: A Review of Effective Therapies and Recommendations for Management. Dermatol Ther (Heidelb) 11(3): 799-831. doi:10.1007/s13555-021-00523-x
9. Menter A, Korman NJ, Elmets CA et al (2009) Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol 61(3):451-485. doi:10.1016/j.jaad.2009.03.027
10. Chat VS, Uppal SK, Kearns DG, Han G, Wu JJ (2021) Translating the 2020 AAD-NPF Guidelines of Care for the Management of Psoriasis With Systemic Nonbiologics to Clinical Practice. Cutis 107(2):99-103. doi:10.12788/cutis.0177
11. Strober BE, Menon K (2005) Folate supplementation during methotrexate therapy for patients with psoriasis. J Am Acad Dermatol 53(4):652-659. doi:10.1016/j.jaad.2005.06.036
12. Baran W, Batycka-Baran A, Zychowska M, Bieniek A, Szepietowski JC (2014) Folate supplementation reduces the side effects of methotrexate therapy for psoriasis. Expert Opin Drug Saf 13(8): 1015-1021. doi:10.1517/14740338.2014.933805
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