Effect of Steroid Intralesional Treatment on Onychodystrophy

Kim, Min Jeong; Hong, Seung Phil; Lee, Won Soo

Abstract

BACKGROUND: Onychodystrophy is a disorder which is still difficult to properly diagnose. Although onychodystrophy has many treatment modalities, such as systemic steroids, topical steroids, steroid intralesional injection, phototherapy, or calcitriol, no method has proven to be totally satisfactory.
OBJECTIVE
The aim of our study was to evaluate the therapeutic effect of intralesional triamcinolone acetonide injection on onychodystrophy.
METHODS
Retrospective analysis was undertaken by reviewing the clinical records of 43 patients who had been diagnosed with onychodystrophy between 1995 and 2005. They were treated with 10 mg/ml triamcinolone intralesional injection to the proximal or lateral nail fold. Intralesional injection was performed at 1~2 month intervals. Of the total 43 patients, 36 patients were scored against 4 grades: Grade 0 (no response), Grade 1 (less than 50% improvement), Grade 2 (less than 75% improvement), and Grade 3 (more than 75% improvement).
RESULTS
Therapeutic effects were as follows; Of 36 patients, 4 (11%) were classified as Grade 1 (less than 50% improvement), 10 (27.8%) as Grade 2 (less than 75% improvement), and 17 (47.2%) as Grade 3 (more than 75% improvement). Trachyonychia was the most common percentage in our study classification. Trachyonychia responded well to treatment and by more than 72.8% more than compared to Grade 2. Furthermore, of the 31 (86.8%) patients who showed a Grade 1 to 3 effect, 14 (39.2%) had less than 4 TA injections in total.
CONCLUSION
Intralesional injection of triamcinolone acetonide into onychodystrophy is a useful, efficacious treatment.