Pulsed dye laser for nail dystrophy: A clinical retrospective case series.

BACKGROUND: Nail dystrophy is relatively common condition that may be idiopathic or may have associated conditions such as twenty-nail dystrophy, psoriasis, onychomycosis and verruca vulgaris. A pathophysiologic mechanism shared by these disorders is inflammation. Treatment of nail dystrophy is difficult, because non-response of these underlying conditions to conventional treatment is commonly encountered. Pulsed dye laser (PDL) targets vascular structures, consequently diminishing inflammation and stimulating tissue remodeling, accounting for its potential benefit in the resolution of nail dystrophy.
OBJECTIVE: To describe  the clinical response of patients with nail dystrophy, due to any cause, to treatment with PDL.
METHODS: This was a retrospective chart review of 28 patients with nail dystrophy, due to any cause in whom, PDL was done at the Dermatology Center of the St. Luke's Medical Center Quezon City from 2002 to August 2013 with or without concomitant medications. Positive response was described as visualization of new normal nail growth, subjective note of improvement of nails and smoothening and thinning of nails. Quality of life, in terms of associated pain, tenderness and cosmetic  disfigurement , was also assessed.
RESULTS: A total of 21 out of 28 (75%) patients demonstrated a positive response to PDL in terms of visualized new normal nail growth with or without concomitant conventional treatment . This was generally observed after the third session of PDL, with sustained improvement among those who continued treatment. Furthermore, these patients reported improved quality of life in terms of decreased pain and better cosmetic appearance with PDL>
CONCLUSION: PDL may be a significant adjunct in the treatment of nail dystrophy, particularly in terms of enhancing response to conventional treatment modalities. It is safe, non-invasive treatment option particulary for patients who have been recalcitrant to conventional medications.