이십손발톱이상증 환자에서 경구 사이클로스포린과 식이보조제 (판토가®) 병합요법의 치료효과

Abstract

Background: Twenty-nail dystrophy (TND) is an acquired idiopathic disease characterized by dull, thin, lusterless, and fragile nails with fissuring, small regular pits, and excessive longitudinal ridging. Although various treatment modalities have been performed in order to treat TND, the effects of these treatments are controversial. Additionally, a pantothenic acid complex-based dietary supplement (Pantogar®) has been used as a supplementary treatment in nail growth. Objective: To evaluate the effectiveness of combination therapy in patients with TND consisting of oral cyclosporine with a pantothenic acid complex-based dietary supplement and to compare its effectiveness with that of treatment with the pantothenic acid complex-based dietary supplement alone. Methods: A total of 38 patients with TND were treated with combination therapy using oral cyclosporine with a pantothenic acid complex-based dietary supplement, whereas 44 patients were treated with the pantothenic acid complex-based dietary supplement alone. The therapeutic efficacy in each group was retrospectively evaluated using medical records and clinical photographs. Results: The combination therapy group had significantly more patients whose improvement was rated as almost clear, marked, or moderate compared to the control group (p<0.001). While the mean CHATS (Color, Hyperkeratosis, Area, Thickness, Separation) score of the combination therapy group was decreased by 13.45 (from 30.95 to 17.5) after treatment, the mean CHATS score of the control group was only decreased by 8 (from 29.43 to 21.43), this difference was statistically significant (p=0.048). Moreover, greater DLQI changes after treatment were observed in the combination therapy group, this difference was also statistically significant (p<0.001). Conclusions: Oral cyclosporine can be a valuable therapeutic option in patients with TND.