A Comprehensive Evaluation of the Efficacy of Intense Pulsed Light and Neodymium-doped Yttrium Aluminum Garnet Laser Treatments in Nail Psoriasis.

INTRODUCTION

Nail psoriasis significantly impairs quality of life and remains therapeutically challenging due to the limited efficacy of treatments.

OBJECTIVES

To compare the clinical efficacy and safety of Nd:YAG laser and intense pulsed light (IPL) therapy in nail psoriasis using total and modified NAPSI scores, clinical and dermatoscopic findings.

METHODS

This retrospective study evaluated 101 nails from 14 patients treated with either IPL (N=66) or Nd:YAG laser (N=35). Treatments were administered every 4-6 weeks for 2-8 sessions. Nail psoriasis severity was assessed at baseline and at six months using NAPSI, mNAPSI, and dermatoscopic and clinical features.

RESULTS

PL therapy significantly reduced matrix (3.48→1.94), nail bed (3.47→1.33), total NAPSI (6.95→3.27), and mNAPSI (9.21→3.92) scores (P<0.05). Nd:YAG laser treatment also resulted in significant improvements in matrix (3.54→2.20), nail bed (3.77→1.97), total NAPSI (7.31→4.17), and mNAPSI (8.83→5.23) scores (P<0.05). In our cohort, IPL appeared to have a more favorable impact on mNAPSI, pitting, salmon patches, subungual hyperkeratosis, and splinter hemorrhages, while Nd:YAG tended to provide greater improvement in leukonychia (P<0.05). No recurrence or adverse event was observed during the 12-month follow-up period.

CONCLUSIONS

Both IPL and Nd:YAG laser therapies are safe and effective options for nail psoriasis. IPL showed superior efficacy in nail bed involvement, whereas Nd:YAG may be preferred for leukonychia. Laser-based treatments are promising alternatives in refractory cases.