A recent study published in the Journal of the American Academy of Dermatology has highlighted the sustained efficacy of Botulinum toxin A (BoNT-A) injection in patients with nail psoriasis, offering up to 6 months of improvement with just a single injection.
Nail psoriasis presents a significant challenge in dermatology due to limited satisfaction with current treatment options. It affects 50% to 79% of individuals with psoriasis, and its management is influenced by factors like the number of affected nails, disease severity, and impact on quality of life .
This randomized intraindividual comparative-controlled study focused on comparing BoNT-A injection with triamcinolone acetonide (TA) injection, a topical combination of vitamin D/steroid (VitD/steroid), and placebo. The study involved 16 patients with a total of 64 psoriatic nails, initially starting with 18 participants .
Results showed significant improvement in nail condition across all treatment groups by week 16, with BoNT-A injection leading to nearly 40% reduction in Nail Psoriasis Severity Index (NAPSI) scores after a single injection. TA injections every 8 weeks also demonstrated a 50% reduction in NAPSI scores, while the combination of topical VitD/steroid showed around a 30% improvement .
Of note, the BoNT-A injection group exhibited continuous improvement at week 24, whereas the TA group maintained stability. Researchers acknowledged study limitations, including a small sample size and short duration, compounded by challenges of the COVID-19 era impacting study conduct .
These findings suggest that BoNT-A injections offer prolonged efficacy compared to TA injections, providing valuable insights into the durability of treatment effects in nail psoriasis management.
