Metotreksat, siklosporin ile tedavi edilen psoriasisli hastalarda psoriatik tırnak değişikliklerinin NAPSI ile takip edilmesi
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Dosyalar
Tarih
2009
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Metotreksat ve siklosporin eskiden beri psoriasis tedavisinde kullanılan iki ajandır. Her iki ilacın tırnak psoriasisi üzerine olan etkinlikleri için yapılan çalışmalar sınırlıdır. Özellikle literatürlerde her iki ilacın tırnak psoriasisi üstüne olan etkinliğini NAPSI skalası ile takip edip karşılaştıran bir çalışma bulunmamaktadır. Çalışmamızda metotreksat ve siklosporin tedavilerinin psoriatik tırnak üzerine olan etkinliklerinin karşılaştırılmasını amaçladık. 34 psoriatik tırnak değişikliği olan psoriasis vulgarisli hasta çalışmamıza alındı. Hastaların demografik ve klinik özellikleri kaydedildi. İlaçlar hastalara randomize olarak verildi. İlaçların etkinliği NAPSI skoru ile kör bir gözlemci tarafından değerlendirildi. Veriler istatistiksel olarak analiz edildi. Metotreksat alan hastaların NAPSI skorunda başlangıca göre azalma %46.2 iken, siklosporin alan hastaların %38.5'ti. Metotreksat ve siklosporin tedavisinin psoriatik tırnak üzerine olan etkinlikleri NAPSI skoru ile karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı. Metotreksat grubunda el matriks skorunda, ayak matriks skorunda ve el yatak skorunda anlamlı azalma saptanırken, ayak yatak skorunda anlamlı azalma tespit edilmedi. Siklosporin grubunda el matriks skoru ve ayak matrix skorunda anlamlı azalma saptanmazken, el yatak ve ayak yatak skorunda belirgin azalma saptandı. Her iki tedavide psoriatik tırnak bulguları üzerine etkinlik sağlamaktadır. Bununla birlikte metotreksat hem matriks hem de yatak bulguları üzerine etkili bulunurken, siklosporin sadece yatak bulgularına etkili olarak saptandı. Bundan dolayı psoriatik tırnak için metotreksat tedavisinin daha uygun bir seçenek olduğunu düşünüyoruz. Yatak tutulumuna bağlı klinik bulgusu fazla olan hastalarda siklosporin tedavisinin kullanılabileceğini öneriyoruz.
Methotrexate and cyclosporine are being used for psoriasis from the past. The researches for evaluating efficacy of these drugs on psoriatic fingernail findings are limited. Especially there are no reports which had used NAPSI score for evaluating and comparing efficacy on psoriatic nails with methotrexate and cyclosporine treatment. We have evealuated the efficacy of methotrexate and cyclosporine on psoriatic nails and have evaluated 34 patients with psoriasis vulgaris who have nail findings. Demographic and clinic features of the patients has been noted. The drugs were given to the patients randomly. The efficacy of the drugs on psoriatic nails has been measured by a blind observer. The results were analyzed statistically. The decrease in NAPSI score of patients who used methotrexate had 46,2 % but, who used cyclosporine 38,5 % from the beginig. At the end of the study there was no statistically important difference between NAPSI scores of the patients who used methotrexate and cyclosporine. The important decrease in hand nail matrix, foot nail matrix, hand nail bed NAPSI scores has been observed who used methotraxate, but there was no decrease in feet nail bed scores. There was no decrease in hand nail matrix, feet nail matrix NAPSI scores of patients who used ciclosporin but there was important decrease in hand nail bed and feet nail bed NAPSI scores. At the end of the study we found that both of the two treatments on psoriatic nails were efficient. Nail matrix and nail bed psoriasis has been treated with methotrexate succesfully, cyclosporine treatment was succesful only on nail bed findings. That?s why we think that the methotrexate treatment is more useful for the psoriatic nails and we recomend cyclosporine treatment for the patients who have nail bed psoriasis.
Methotrexate and cyclosporine are being used for psoriasis from the past. The researches for evaluating efficacy of these drugs on psoriatic fingernail findings are limited. Especially there are no reports which had used NAPSI score for evaluating and comparing efficacy on psoriatic nails with methotrexate and cyclosporine treatment. We have evealuated the efficacy of methotrexate and cyclosporine on psoriatic nails and have evaluated 34 patients with psoriasis vulgaris who have nail findings. Demographic and clinic features of the patients has been noted. The drugs were given to the patients randomly. The efficacy of the drugs on psoriatic nails has been measured by a blind observer. The results were analyzed statistically. The decrease in NAPSI score of patients who used methotrexate had 46,2 % but, who used cyclosporine 38,5 % from the beginig. At the end of the study there was no statistically important difference between NAPSI scores of the patients who used methotrexate and cyclosporine. The important decrease in hand nail matrix, foot nail matrix, hand nail bed NAPSI scores has been observed who used methotraxate, but there was no decrease in feet nail bed scores. There was no decrease in hand nail matrix, feet nail matrix NAPSI scores of patients who used ciclosporin but there was important decrease in hand nail bed and feet nail bed NAPSI scores. At the end of the study we found that both of the two treatments on psoriatic nails were efficient. Nail matrix and nail bed psoriasis has been treated with methotrexate succesfully, cyclosporine treatment was succesful only on nail bed findings. That?s why we think that the methotrexate treatment is more useful for the psoriatic nails and we recomend cyclosporine treatment for the patients who have nail bed psoriasis.
Açıklama
Anahtar Kelimeler
Metotreksat, Methotrexate, Siklosporin, Cyclosporine, Psoriasis
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Gümüşel, M. (2009). Metotreksat, siklosporin ile tedavi edilen psoriasisli hastalarda psoriatik tırnak değişikliklerinin NAPSI ile takip edilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Deri ve Zührevi Hastalıklar Anabilim Dalı, Konya.
