Topical High Dose Vitamin D<sub>3</sub> Therapy with Occulusive Dressing Technique for Nail Psoriasis

  • Mitani Arifumi
    Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences
  • Isomura Iwao
    Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences
  • Morita Akimichi
    Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences

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Other Title
  • 乾癬爪に対する活性型ビタミンD<sub>3</sub>外用密封療法
  • 乾癬爪に対する活性型ビタミンD₃外用密封療法
  • カンセンツメ ニ タイスル カッセイガタ ビタミン D ₃ ガイヨウ ミップウ リョウホウ

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Description

The nail is commonly involved in patients with psoriasis. Various therapies for nail psoriasis have been attempted ; however, nail lesions are refractory to topical and systemic therapies including oral retinoid, cyclosporine A, and topical steroid. In this study, we investigated the effectiveness of topical high dose vitamin D3 therapy with occulusive dressing technique (ODT) on the nail lesions in 8 cases of psoriasis vulgaris and 3 cases of psoriaris pastulosa. We applied calcipotriol ointment (50 μg/g) to an affected nail and the periungual tissue once a day for a few weeks. The treatment was expanded to other nail lesions when the initial therapy was effective. The effectiveness was evaluated by using nail psoriasis severity index (NAPSI). The results revealed that three months of calcipotriol ODT treatment was effective in seven out of eleven patients. Adverse effects such as irritation, periungual scaling, erythema, and nail loss were observed. The psoriatic lesions on the trunk and extremities did not change during this therapy. Topical high dose vitamin D3 ODT therapy is effective for nail psoriasis and considered to be a useful and safe alternative for the treatment of nail psoriasis.

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