LAUSR

Dear Editor, Psoriasis is a chronic inflammatory skin disease characterized by recurrent events. Its prevalence around the world is approximately 1-3%.1,2 It ́s estimated that 80-90% of patients with psoriasis will present with nail disorders throughout their lives.2,3 Studies have shown that nail psoriasis is the causes a significant social problem, often associated with pain.2 Different therapeutic options can be found for nail psoriasis, which include topical medication, intralesional treatment, systemic therapy, conventional therapies with immunobiological drugs, as well as non-pharmacological treatments.2,3 Methotrexate (MTX) is a folic acid analogue, responsible for inhibiting the synthesis of deoxyribonucleic acid.2,3 A literature review shows that intralesional MTX has been successfully used for several indications with no complications reported. The treatment of nail psoriasis has still yielded unsatisfactory results, leading doctors to search for more effective therapeutic approaches.2 Case 1. We report a 45-year-old female patient with nail dystrophy for 2 years referred for onychomycosis treatment. She presented with exuberant subungual hyperkeratosis and discrete cupuliform depressions, in addition to erythema, periungual edema, and pain in the right hallux (Figure 1). No changes were observed in the other nails. We observed no other alterations on physical examination. Direct mycological examination, repeated weekly for 4 weeks, was always negative. MRI of the hallux confirmed the Nail psoriasis treated with intralesional methotrexate infiltration*