A Retrospective Study of Comparison between Dexamethasone Iontophoresis versus Intralesional Triamcinolone Acetonide in Nail Psoriasis in Same Patient

INTRODUCTION: Psoriasis is a chronic inflammatory disease charaterized by T cell mediated hyperproliferation of keratinocytes in the skin. Nail psoriasis may show different clinical presentations according to the structure that is involved within the nail unit. We did a retrospective study to describe efficacy of Dexamethasone Iontophoresis versus Intralesional Triamcinolone Acetonide in nail psoriasis in same patient. METHODS: 72 patients were enrolled in the study who were given Dexamethsone Iontophoresis in right hand fingernails and Intralesional Triamcinolone Acetonide in left hand fingernails. They were followed for a period of 18 months. Patients were treated with weekly Dexamethasone Iontophoresis and monthly injections of Intralesional Triamcinolone Acetonide. RESULTS: Pitting, Leukonychia, Nail plate crumbling, Lunular erythema, Onycholysis, Subungual hyperkeratosis, Salmon patch, Splinter haemorrhages were observed in both hand fingernails. Pitting was the most common finding followed by onycholysis, nail plate crumbling and subungual hyperkeratosis. The results were satistically analysed using paired t test. The data was presented as MEAN+SD and p value was calculated. After the statistical analysis the p value was found to be significant ( less than0.0001) showing that Dexamethasone iontophoresis is more efficacious than Intralesional Triamcinolone Acetonide in nail psoriasis. CONCLUSION: In our study we found that Dexamethasone Iontopheresis is more efficacious than Intralesional Triamcinolone acetonide in treatment of nail psoriasis in same patient with no side effects whereas Intralesional Triamcinolone acetonide injection causes pain and atrophy of nail matrix.