Onycholysis Successfully Treated with Triamcinolone Intralesional Injection and Cryotherapy: Report of 5 Cases

Background: Onycholysis is a detachment of the nail plate from the nail bed, which occurs at distal portion of nail plate. It is commonly associated
with many diseases and conditions, including psoriasis, lichen planus, onychomycosis and trauma.
Objectives: To evaluate the clinical efficacy of triamcinolone intradermal injection (TA ILI) and Cryotherapy on the patients with Onycholysis.
Methods: Retrospective chart reviews and photographic analysis were performed for patients with Onycholysis. TA was injected at the hyponychium.
Cryotherapy was sprayed on hyponychium and between nail plate and nail bed lesions showing subungual hyperkeratosis. Clinical improvement
was assessed by two blinded physicians using 5-point global assessment scale.
Results: 5 patients (2 males, 3 females, mean age 48.0 ± 15.8 years) were analysed. Total 11 nails, consisted of 10 finger nails and 1 toe nail, were
treated with TA ILI and Cryotherapy. Patients got these modalities simultaneously. Mean treatment session were 5.2 ± 2.5 times. After combined TA
ILI and Cryotherapy, all patients (100 %) showed more than 50% improvement. Using Image J analysis, average 75.8% involved nail bed area showed
improvement after treatment. There was no report for persistent and serious adverse event associated with the treatment during follow-up period.