OBJECTIVE

To evaluate the effectiveness of psoriatic onychodystrophy therapy involving a pulsed dye laser and local darsonvalization regarding long-term results.

MATERIAL AND METHODS

The study enrolled 110 patients with nail psoriasis. Of these, 101 and 93 patients underwent examination after 6 and 12 months, respectively. All patients received basic therapy (calcipotriol ointment to the nail folds twice a day for 6 months). All patients were randomized into 4 groups. Patients of the first group (control) received only basic therapy, the second group — 3 courses of local darsonvalization in addition to basic therapy, the third group — basic therapy and pulsed dye laser, the fourth group — basic therapy with local darsonvalization combined with pulsed dye laser. The effectiveness of therapy in patients with psoriatic onychodystrophy was assessed considering NAPSI and DQLI scores.

RESULTS

Stable effect achieved at the point after treatment depended on treatment regimen. In the control group, there was regression of clinical result with recurrent signs characterizing damage to the nail matrix and bed. In the 2^nd and 3^rd groups, we observed more stationary dynamics of parameters. Pulsed dye laser was accompanied by less pronounced regression of clinical result after treatment compared to local darsonvalization. The most favorable dynamics of clinical manifestations of psoriatic onychodystrophy was recorded after complex therapy.

CONCLUSION

The greatest long-term efficiency regarding duration of remission is observed after complex physiotherapeutic effects. This is due to synergistic interaction of therapeutic physical factors that are different in their physical nature, points of application and mechanisms of therapeutic activity. Taking into account chronic nature of disease and dynamics of clinical manifestations, repeated courses of therapy are recommended 9—12 months after the main course of therapy.