Safety and efficacy of intralesional triamcinolone in the treatment of nail psoriasis: A systematic review and meta-analysis

Nail psoriasis is a chronic and disfiguring manifestation of psoriasis that substantially affects quality of life. Intralesional triamcinolone acetonide (ILTAC) is commonly used for localized disease, yet its efficacy and safety remain incompletely established. This systematic review and meta-analysis aimed to evaluate the therapeutic effectiveness and safety of ILTAC in nail psoriasis and to summarize key clinical and methodological features of available studies. The review followed PRISMA guidelines and was registered in the PROSPERO database. Comprehensive searches of 5 electronic databases through September 2023 identified 6 eligible studies, including randomized trials and observational cohorts, that evaluated ILTAC using standardized outcome measures such as the Nail Psoriasis Severity Index. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool for randomized trials and the MINORS tool for nonrandomized studies. Pooled analysis demonstrated that ILTAC significantly improved nail psoriasis, with an overall odds ratio of 2.35 (95% CI, 1.20–4.60) and negligible heterogeneity (I²= 0%). Adverse events were generally mild and transient, with pain being the most frequently reported side effect, and no systemic adverse reactions were noted. These findings confirm that ILTAC is an effective and safe localized therapy for nail psoriasis, although optimal maintenance strategies require further investigation.