{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:53:09Z","timestamp":1788187989242,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment of nail psoriasis is disappointing; due to poor penetrability of topical therapies and variable efficacy of systemic therapies. Fractional carbon dioxide laser (FCL) may enhance penetration of topical therapy for nail psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy and safety of FCL plus\u2009topical tazarotene versus tazarotene monotherapy in the treatment of nail psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010seven patients with bilateral fingernail psoriasis randomly received 3\u00a0sessions of FCL at four\u2010week interval plus once\u2010daily tazarotene 0.1% gel for one hand, and once\u2010daily tazarotene 0.1% gel only for 3\u00a0months on the other hand. The primary outcome was modified Nail Psoriasis Severity Index (mNAPSI) at 3 and 6\u00a0months compared to baseline, and the secondary outcomes included dermoscopic examination and patient global assessment. Adverse events were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total, nail matrix, and nail bed mNAPSI scores were significantly improved at 3 and 6\u00a0months by both regimens, but they decreased more after FCL\/tazarotene combination (<jats:italic>p<\/jats:italic> = 0.001, <jats:italic>p<\/jats:italic> = 0.023, and <jats:italic>p<\/jats:italic> = 0.001, respectively). Combination therapy showed faster improvement of nail matrix signs and greater efficacy for nail bed signs. The dermoscopic features of the nail plate were the most responsive after both treatments. The combined therapy was more effective in improving the dermoscopic nail bed features. Patient's global assessment scores were significantly higher after the combined therapy. Both treatments were well tolerated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fractional CO<jats:sub>2<\/jats:sub>\u00a0laser is an effective and well\u2010tolerated treatment for nail psoriasis; it improves the outcomes of topical tazarotene especially in nail bed lesions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14536","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T09:37:08Z","timestamp":1634809028000},"page":"2808-2816","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Efficacy of combined fractional carbon dioxide laser and topical tazarotene in nail psoriasis treatment: A randomized intrapatient left\u2010to\u2010right study"],"prefix":"10.1111","volume":"21","author":[{"given":"Nagwa","family":"Essa Abd Elazim","sequence":"first","affiliation":[{"name":"Dermatology, Venereology and Andrology Department Assiut University Hospital  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayat","family":"Mahmoud Abdelsalam","sequence":"additional","affiliation":[{"name":"Dermatology, Venereology and Andrology Department Assiut University Hospital  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0664-6358","authenticated-orcid":false,"given":"Sara","family":"Mohamed Awad","sequence":"additional","affiliation":[{"name":"Dermatology, Venereology and Andrology Department Assiut University Hospital  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"CD007633","article-title":"Interventions for nail psoriasis","volume":"1","author":"Vries AC","year":"2013","journal-title":"Cochrane Database Syst 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