Korean J Dermatol.  2020 Jun;58(5):299-304.

Effect of Oral Alitretinoin Therapy on Trachyonychia

• Park HE
• Yoo SA
• Park HJ
• Kim M

Abstract

Background
Trachyonychia is a condition characterized by longitudinal ridging, pitting, and roughness of the nail surface. It tends to be resistant to various treatment modalities, often leading to a clinically unsatisfactory outcome. Alitretinoin (9-cis-retinoic acid; Alitoc Capsule) is approved for patients with severe chronic hand eczema and has been shown to be effective for other skin diseases. However, only few studies have demonstrated the efficacy of oral alitretinoin for the treatment of trachyonychia.
Objective
We aimed to evaluate the efficacy and safety of oral alitretinoin therapy for the treatment of trachyonychia.
Methods
We reviewed the medical records and clinical photographs of patients with trachyonychia who were treated with oral alitretinoin therapy between January 2016 and December 2019 in the Department of Dermatology of Yeouido St. Mary’s Hospital. Photographs of the lesions were taken and evaluated at 0, 1, 3, 6, and 12 months. The severity of trachyonychia was assessed into 5 grades according to the roughness of the nail and the distribution of affected areas.
Results
Thirty patients (male: 12, female: 18) with a mean age of 51.5±11.1 years were included in the study. After treatment with oral alitretinoin at a dosage of 10∼30 mg/day, the severity of trachyonychia tended to decrease as the number of treatment sessions increased. The mean treatment duration was 6.9±4.1 months. The therapeutic effects were as follows. After 3 months of treatment, 88.0% of the patients showed partial remission, and all the patients showed improvement after ＞6 months of treatment. After 12 months of treatment, 20.0% of the patients achieved complete remission.
Conclusion
Oral alitretinoin therapy may be an effective and safe treatment option for trachyonychia.

Keyword

Alitretinoin; Onychodystrophy; Trachyonychia