excimer for nail psoriasis


Status: Not yet recruiting
Keywords: psoriasis , fingernail , excimer , laser
IRB Number: 00067130
Specialty: Dermatology, Dermatology
Sub Specialties: Laser and Cosmetic Dermatology, Psoriasis and Phototherapy

Brief Summary



1.     To assess the efficacy of 8 weeks of excimer laser in treating fingernail psoriasis in a randomized, blinded, right-left comparison trial. Due to slow growth rate of fingernails, final efficacy assessment will be performed at week 16.

a.     To compare the mean improvement in target nail mNAPSI score [Modified Nail Psoriasis Severity Score] of excimer laser treated (EL) hand compared to sham treated hand.

b.     To assess the proportion of patients achieving NAPSI 50 and NAPSI 75 (50% and 75% improvement, respectively) at week 16.

c.     To assess the proportion of patients with no nail psoriasis (overall NAPSI sore of 0) at weeks 16.

d.     To compare changes from baseline in physician’s and patient’s assessment of nail psoriasis activity [visual analogue scale (VAS); range of 0 (no nail disease) to 100 (worst possible nail disease)].

2.     To assess the adverse events associated with excimer laser treatment of nail psoriasis.

a.     To compare immediate and delayed symptoms in excimer treated fingers compared to sham treated fingers.

Principal Investigator: Kristina Duffin
Department: Dermatology
Co Investigator: Kristina Duffin
Co Investigator: Gerald Krueger

Contact Information

Name:Razieh Soltani - Arabshahi
Phone: 801 581 6465
Email: razi.soltani@hsc.utah.edu

Inclusion Criteria


·      Must give written informed consent.

·      Must be at least 18 years old.

·      Must have been diagnosed with stable fingernail psoriasis.

·      Must have fairly symmetric fingernail psoriasis in right and left hand with similar mNAPSI scores in right and left hand target nails. Target nail is defined as the fingernail with highest mNAPSI score.

·      Must have active fingernail psoriasis, defined as a target fingernail matrix NAPSI score ≥ 2 and mNAPSI score from a combination of crumbling, onycholysis and pitting ≥ 2. 

·      No changes in the systemic therapy or nail directed topical therapy during the 16-week study period.

Exclusion Criteria


·      Subjects unable to tolerate frequency of visits.

·      History of intolerance to or worsening of psoriasis with ultraviolet light.

·      Current use of known photosensitizing medications.

·      History of Fitzpatrick Type I skin, photosensitivity, or keloid formation.

·      Any new systemic psoriasis therapy (biologics, conventional systemic immunomodulators, phototherapy) or nail directed topical therapy for the last 3 months prior to enrollment. 

·      Any other condition that in the eyes of the investigator will disqualify patient from the study.