The conventional treatment of nail psoriasis is associated with adverse effects and difficulty in drug delivery. This study compared conventional treatment with topical steroids to microneedle technology for steroid delivery to treat nail psoriasis and found that microneedle technology combined with topical steroids was equally effective and did not cause severe side effects.
The treatment of nail psoriasis is complex owing to the difficult drug delivery methods and toxicity associated with systemic therapy. Self-dissolving microneedle patches that deliver corticosteroids provide a minimally invasive drug delivery system with fewer side effects and good treatment efficacy.
This study was a prospective randomized controlled trial, conducted over 4 months and published in the Annals of the Academy of Medicine, Singapore. In this study, 25 participants were recruited for the trial. They were randomized equally to control and triamcinolone treatment groups. The participants received topical Daivobet gel on one hand, and the triamcinolone treatment, consisting of a microneedle device with topical steroids on the other hand. Independent and blinded psychologists evaluated the psoriatic nails by assigning Nail Psoriasis Severity Index (NAPSI) scores at baseline, 2 months, and 4 months.
The investigators observed significant and rapid improvement in the control group at 2 months, as represented by the average NAPSI score. However, the treatment hand comprising microneedle devices with topical steroids showed a greater and more sustained improvement in the average NAPSI score at 4 months. The average NAPSI improved in both control and treatment groups at 4 months compared to the baseline. The only statistically significant improvement in the NAPSI score was observed in the control hand at 2 months. The study reported no severe side effects.
The study concluded that the efficacy of microneedle technology with topical steroids is comparable to conventional topical therapy for nail psoriasis. With a longer treatment period and follow-up, the microneedle patch may produce more promising results. Further studies could be carried out with larger sample size.
References
1. Yew, Y. W., Phuan, C., Zhao, X., Tan, E., Chong, W. S., & Tey, H. L. (2022). Novel transdermal device for delivery of triamcinolone for nail psoriasis treatment. Annals of the Academy of Medicine, Singapore, 51(1), 16–23.
https://doi.org/10.47102/annals-acadmedsg.2021380
