Limits...
Nail Lichen Planus: Successful Treatment with Etanercept.

Irla N, Schneiter T, Haneke E, Yawalkar N - Case Rep Dermatol (2010)

Bottom Line: CASE REPORT: We report a case of lichen planus limited to the toe nails successfully treated with etanercept monotherapy.CONCLUSION: The significant improvement of our case suggests that etanercept is an effective treatment modality for lichen planus limited particularly to the nails.Further controlled studies are needed to establish the effectiveness and therapeutic regimes.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Bern University Hospital and University of Bern, Bern, Switzerland.

ABSTRACT
BACKGROUND: Etanercept is a fully human tumor necrosis factor a receptor fusion protein that binds tumor necrosis factor a with greater affinity than natural receptors. Biologics are widely used in the treatment of psoriasis and psoriasis arthritis and may represent a new therapeutic option for some patients with psoriatic nail disease. CASE REPORT: We report a case of lichen planus limited to the toe nails successfully treated with etanercept monotherapy. CONCLUSION: The significant improvement of our case suggests that etanercept is an effective treatment modality for lichen planus limited particularly to the nails. Further controlled studies are needed to establish the effectiveness and therapeutic regimes.

No MeSH data available.


Related in: MedlinePlus

Clinical findings of the patient before (a), 3 months (b) and 9 months (c) after etanercept monotherapy (25 mg s.c. twice weekly for the first 6 months and 50 mg s.c. once weekly thereafter).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC2992401&req=5

Figure 2: Clinical findings of the patient before (a), 3 months (b) and 9 months (c) after etanercept monotherapy (25 mg s.c. twice weekly for the first 6 months and 50 mg s.c. once weekly thereafter).

Mentions: A 53-year-old Caucasian woman was referred to our department for evaluation of onychodystrophy involving multiple fingers and toe nails. The painful nail changes had progressively appeared over the past 5 years and were extremely disabling in daily living activities. Except for an atopic constitution with chronic eczema and seasonal allergic rhinoconjunctivitis, her past medical history was noncontributory and she was not on any regular systemic medication. Clinical examination of the affected nails showed onychodystrophy, discoloration, subungual hyperkeratosis as well as some longitudinal ridging, striation, splitting and thinning (fig. 1). The diagnosis of nail LP was made based on these clinical features. The patient had no other evidence of skin or mucosal involvement of LP or psoriasis. Since several topical treatments, including potent topical steroids, topical cyclosporine, tazarotene cream and systemic retinoids, had been ineffective, treatment with systemic cyclosporine 250 mg/day (3 mg/kg body weight) was initiated, which lead to significant improvement of most nails. However, since the patient developed arterial hypertension, treatment with cyclosporine was discontinued after 3 years. A relapse particularly of her toe nails occurred within a few weeks. Therapy with etanercept (25 mg s.c. twice weekly for the first 6 months and 50 mg s.c. once weekly thereafter) was then initiated, which again lead to a marked improvement of her toe nail lesions within 6-9 months (fig. 2). Therapy was well tolerated with no side-effects.


Nail Lichen Planus: Successful Treatment with Etanercept.

Irla N, Schneiter T, Haneke E, Yawalkar N - Case Rep Dermatol (2010)

Clinical findings of the patient before (a), 3 months (b) and 9 months (c) after etanercept monotherapy (25 mg s.c. twice weekly for the first 6 months and 50 mg s.c. once weekly thereafter).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2992401&req=5

Figure 2: Clinical findings of the patient before (a), 3 months (b) and 9 months (c) after etanercept monotherapy (25 mg s.c. twice weekly for the first 6 months and 50 mg s.c. once weekly thereafter).
Mentions: A 53-year-old Caucasian woman was referred to our department for evaluation of onychodystrophy involving multiple fingers and toe nails. The painful nail changes had progressively appeared over the past 5 years and were extremely disabling in daily living activities. Except for an atopic constitution with chronic eczema and seasonal allergic rhinoconjunctivitis, her past medical history was noncontributory and she was not on any regular systemic medication. Clinical examination of the affected nails showed onychodystrophy, discoloration, subungual hyperkeratosis as well as some longitudinal ridging, striation, splitting and thinning (fig. 1). The diagnosis of nail LP was made based on these clinical features. The patient had no other evidence of skin or mucosal involvement of LP or psoriasis. Since several topical treatments, including potent topical steroids, topical cyclosporine, tazarotene cream and systemic retinoids, had been ineffective, treatment with systemic cyclosporine 250 mg/day (3 mg/kg body weight) was initiated, which lead to significant improvement of most nails. However, since the patient developed arterial hypertension, treatment with cyclosporine was discontinued after 3 years. A relapse particularly of her toe nails occurred within a few weeks. Therapy with etanercept (25 mg s.c. twice weekly for the first 6 months and 50 mg s.c. once weekly thereafter) was then initiated, which again lead to a marked improvement of her toe nail lesions within 6-9 months (fig. 2). Therapy was well tolerated with no side-effects.

Bottom Line: CASE REPORT: We report a case of lichen planus limited to the toe nails successfully treated with etanercept monotherapy.CONCLUSION: The significant improvement of our case suggests that etanercept is an effective treatment modality for lichen planus limited particularly to the nails.Further controlled studies are needed to establish the effectiveness and therapeutic regimes.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Bern University Hospital and University of Bern, Bern, Switzerland.

ABSTRACT
BACKGROUND: Etanercept is a fully human tumor necrosis factor a receptor fusion protein that binds tumor necrosis factor a with greater affinity than natural receptors. Biologics are widely used in the treatment of psoriasis and psoriasis arthritis and may represent a new therapeutic option for some patients with psoriatic nail disease. CASE REPORT: We report a case of lichen planus limited to the toe nails successfully treated with etanercept monotherapy. CONCLUSION: The significant improvement of our case suggests that etanercept is an effective treatment modality for lichen planus limited particularly to the nails. Further controlled studies are needed to establish the effectiveness and therapeutic regimes.

No MeSH data available.


Related in: MedlinePlus