In this study, we examined the efficacy of a vitamin D3 lotion as a topical treatment for nail psoriasis. Thirty cases with psoriasis vulgaris were monitored for adherence to the therapy, and improvements in nail plate psoriasis, nail bed psoriasis, and nail psoriasis severity index (NAPSI) score were assessed. Subsequently, we investigated whether the quality of the topical lotion or the region of topical application were responsible for poor adherence. The percentage change from baseline NAPSI score with maxacalcitol lotion was significantly higher as compared to controls. In addition, the maxacalcitol lotion applied to the nail plate showed significant improvements as compared to controls. The vitamin D3 lotion showed fair improvements in nail psoriasis. Patients who had few lesions in the nail bed or who mainly applied lotion to the nail matrix showed particularly good results. Some patients did not apply the lotion every day. We also discuss herein several points related to adherence to topical treatments for nail psoriasis.
A 50-year-old man was stung in the dorsal aspect of his right hand by a freshwater stingray while taking care of it in his aquarium. Although the patient received antibiotics and irrigation of the wound, a deep ulcer developed. After the thorough debridement of the ulcer, it healed completely three months after the injury. Stingrays are one of the most dangerous marine animals for men. The sting is poisonous and causes a painful wound, delayed healing, and sometimes death. To our knowledge, there are no previous reports on envenomation by freshwater stingrays in Japan. We need to recognize how to treat the intense pain after the envenomation and the deep ulcer.
To evaluate the efficacy of brand name and generic moisturizers, we examined their effects on dried skin models of five healthy subjects. The heparinoid lotion and cream of the brand name and generic were applied twice daily for 10days, and the water content of the stratum corneum was compared. As a result, the brand name lotion and cream increased the water content significantly more than the generic. If generic substitutions are to be used for brand name formulations, physicians must be aware that significant differences in therapeutic effectiveness may be expected.