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Twenty-nail dystrophy treated with topical PUVA
L Halkier-Sørensen1, M Cramers, K Kragballe
1Department of Dermato-Venereology, University of Aarhus, Marselisborg Hospital, Denmark.
Acta Dermato-Venereologica
|January 1, 1990
Summary
Topical PUVA therapy effectively treated twenty-nail dystrophy in a young woman, significantly improving fingernail condition. Maintenance therapy was crucial to prevent recurrence of this nail disorder.
Area of Science:
- Dermatology
- Phototherapy
Background:
- Twenty-nail dystrophy is a benign, self-limiting nail disorder of unknown etiology.
- It typically affects children and adolescents, presenting with longitudinal ridging and pitting of all fingernails and toenails.
Observation:
- A 19-year-old female patient presented with a 4-year history of twenty-nail dystrophy affecting all fingernails and toenails.
- The fingernails were treated with topical PUVA (psoralen plus ultraviolet A) therapy at a dose of 0.7-1.4 J/cm2, three times per week.
Findings:
- After 7 months of treatment, excellent improvement was observed in the fingernails.
- The untreated toenails showed no improvement, indicating a localized effect of the topical PUVA therapy.
- A reduced maintenance dose of 0.7 J/cm2, three times per week, was required to prevent relapse.
Implications:
- Topical PUVA therapy demonstrates potential efficacy in treating twenty-nail dystrophy, particularly when localized to the fingernails.
- This treatment modality warrants consideration for patients with twenty-nail dystrophy unresponsive to or seeking alternatives to other therapies.
- Further research may explore optimal dosing and long-term outcomes of topical PUVA for various nail dystrophies.