Abstract:
:Nail involvement can place a significant burden on patients as a result of functional damage and psychosocial problems, leading to major repercussions on the quality of life. There is strong evidence that nail psoriasis can often be difficult to treat. We report a 69-year-old man with severe onychodystrophy, onycholysis, and pain in the hands; he had been previously treated with topical and systemic traditional therapies without satisfactory response. The patient showed multiple severe psoriatic crumbly nails (nail psoriasis severity index [NAPSI] score of 69) and started ustekinumab treatment at standard dosage of 45 mg fl.s.c. After 24 weeks, both nail matrix and nail bed disease showed marked improvement and the patient continued therapy with ustekinumab (NAPSI 0 at week 104). At week 136 (September 2015), the patient had been complaining of hands pain (visual analogue scale pain: 80) and ultrasonographic (US) evaluations found a synovial proliferation with effusion on metacarpophalangeal joints. The patient continued therapy with ustekinumab, adding methotrexate 10 mg fl.s.c/week. In November 2016, the patient showed a remission of symptoms; clinical and US evaluations did not find signs of synovitis. Methotrexate treatment was suspended and currently the patient reached more than 4 years of ustekinumab treatment without sign and symptoms of synovitis.
journal_name
Dermatol Therjournal_title
Dermatologic therapyauthors
Galluzzo M,D'Adamio S,Chimenti MS,Teoli M,Bianchi L,Talamonti Mdoi
10.1111/dth.12914subject
Has Abstractpub_date
2019-05-01 00:00:00pages
e12914issue
3eissn
1396-0296issn
1529-8019journal_volume
32pub_type
杂志文章abstract::Plantar warts are a common reason for dermatological consultations and their treatment can occasionally be a challenge. Plantar warts are benign lesions produced by the human papillomavirus (HPV) that often fail to respond to habitual treatment. Cidofovir is a potent antiviral drug that acts competitively, inhibiting ...
journal_title:Dermatologic therapy
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journal_title:Dermatologic therapy
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journal_title:Dermatologic therapy
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journal_title:Dermatologic therapy
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