Intramatricial injection of anti-IL-17A Ab efficacious in nail psoriasis : CED study

Nail involvement is a common feature of psoriasis commonly overlooked by physicians. It affects approximately 10-78% of psoriasis patients with 5-10% of patients having isolated nail psoriasis.² Its significant association with arthritis, its resistance to treatment and psychological stress it causes in patients makes it an important feature of psoriasis which needs attention and treatment. IL-17 monoclonal antibodies have been one of the successful biologicals in the treatment of psoriasis. Recently a study describing efficacy of intramatricial injection of anti-IL-17A Ab in nail psoriasis was published in the Clinical and Experimental Dermatology journal.

6 patients with psoriasis vulgaris and NP were recruited- 3 males and 3 females (age: 33.2± 11.1 years, skin psoriasis duration: 8.3± 4.1 years, NP duration: 3.2±1.5 years, PASI: 2.6±0.6). The number of involved fingernails was 9.2±1.3. All the patients received topical corticosteroids and/or vitamin D3 analogues without any systemic treatment in the past 3 months.

Each patient received local anaesthesia with 5% lidocaine and 1% tetracaine under occlusion for an hour in proximal nail fold. 3 severe nails of left hand were treated with intramatricial injections of secukinumab in different concentrations, 7.5mg/ml, 15mg/ml and 30mg/ml respectively formed by dilution with sterile water and preserved at 4℃. The needle was inserted from the two sides of the proximal nail fold in a 'V' pattern to inject 0.05 ml each side every time. Patients received 5-6 times treatments with a 2-week interval.