SCALP PSORIASIS - TOPICAL ISSUES OF DIAGNOSIS AND THERAPY


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. Psoriatic rashes can be localized on any areas of the skin, while the scalp is involved in the process in 80% of cases. The therapy of psoriasis patients with localization of the process on the scalp is quite difficult for clinicians and includes not only the treatment of exacerbations of dermatosis, but also maintenance therapy aimed at prolonging remission. Objective. To evaluate the efficacy and safety of using betamethasone+calcipotriol (Xamiol) fixed combination in the treatment of exacerbations and as maintenance therapy for patients with scalp psoriasis. Methods. 69 patients were under observation. In case of mild-to-moderate course of the process (Group 1), patients received monotherapy with Xamiol up to 8 weeks. In the severe course of the process (Group 2), patients used keratolytic for 15-20 minutes with occlusive dressing to eliminate the prominent scaly crusts, and after washing the keratolytic, the Xamiol gel was applied. At the second stage of the observation, patients with achieved clinical remission or significant improvement (PASI - Psoriasis Area Severity Index К3 points) either used Xamiol on demand (Group 3) or by intermittent scheme 1-2 times a week (Group 4) until the onset of another exacerbation. Results. In the Group 1, the PASI index was reduced by 82.7%, in the Group 2 - by 80.3%. DLQI (Dermatology Life Quality index) decreased by 80.9%, in the Group 2 - by 76.9%. In the Group 3, maintenance on-demand therapy allowed to control the process in 82.6% of patients. In Group 4, 90.6% of patients using the intermittent scheme had no negative dynamics - the PASI index persisted in the confidence interval Q1=0.2; Q3=4.8 points, which allowed the long-term control of the disease: PASI index <5 points, while 46.9% of patients had no exacerbations for 12 months against the background of intermittent therapy. Conclusion. Calcipotriol / betamethasone dipropionate fixed combination in the form of a gel is an effective and well-tolerated method of therapy of exacerbations and maintenance therapy for psoriasis with the localization of the process on the scalp.

Full Text

Restricted Access

About the authors

L. S Kruglova

Central State Medical Academy of Affairs Management Department of the President of the Russian Federation

Email: kruglovals@mail.iu
MD, Prof., Head of the Department of Dermatovenereology and Cosmetology

S. N Turbovskaya

Central State Medical Academy of Affairs Management Department of the President of the Russian Federation

A. A Khotko

Central State Medical Academy of Affairs Management Department of the President of the Russian Federation

References

  1. Griffiths C.E., Barker J.N. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263-71.
  2. Lowes M.A., Bowcock A.M., Krueger J.G. Pathogenesis and therapy of psoriasis. Nature 2007;445:866-73.
  3. Drew G.S. Psoriasis. Prim. Care. 2000;23(2): 385-406.
  4. Cloote H. Psoriasis. Clin. Exp. Dermatol. 2000;14(15):47-52.
  5. Потекаев Н.Н., Круглова Л.С. Псориатическая болезнь. М., 2014. 264 с. [Potekaev N.N., Kruglov L.S. Psoriatic disease. Moscow, 2014. 264p. (In Russ.)].
  6. Papp K., et аі Cost-effectiveness evaluation of CPS maintenance in patients with moderate scalp psoriasis a Pan-European analysis. J. Eur. Acad. Dermatol. Venereol. 2012;26(11):1407-14.
  7. Pearce D.J., Stealey K.H., Balkrishnan R., et al. Psoriasis. treatment in the United States at the end of the 20th century. Int. J. Dermatol. 2006;45:370-74.
  8. Ortonne J.P., Chimenti S., Luger T., et al. Scalp psoriasis: European consensus on grading and treatment algorithm. JEADV 2009. doi: 10.1111/j.1468-3083.2009.033 72.x.
  9. Kragballe K., van de Kerkhof P. Pooled safety analysis of calcipotriol plus betamethasone dipropionate gel for the treatment of psoriasis on the body and scalp. J. Eur. Acad. Dermatol. Venereol. 2014;289(Suppl. 2):10-21.
  10. Morita A., Muramatsu S., Kubo R., et al. Low incidence of hypercalcemia following combined calcipotriol hydrate/betamethasone dipropionate ointment treatment in Japanese patients with severe psoriasis vulgaris. J. Dermatolog. Treat. 20184;10:1-5.
  11. Norsgaard H., Kurdykowski S., Descargues P., et al. Calcipotriol counteracts betamethasone-induced decrease in extracellular matrix components related to skin atrophy. Arch. Dermatol. Res. 2014;306(8):719-29.
  12. Kragballe K., Austad J., Barnes L., et al. Efficacy results of a 52-week, randomised, double-blind, safety study of a calcipotriol/betamethasone dipropionate two-compound product (Daivobet/ Dovobet/Taclonex) in the treatment of psoriasis vulgaris. Dermatology. 2006;213(4):319-26.
  13. Nast A., Kopp I., Augustin M., et al. German evidence-based guidelines for the treatment of psoriasis vulgaris (short version). Arch. Dermatol. Res. 2007; 299(3):111-38.
  14. Laws P.M., Young H.S. Topical treatment of psoriasis. Expert. Opin. Pharmacother. 2010;11(12): 1999-2009.
  15. Bottomley J.M., Taylor R.S., Ryttov J. The effectiveness of two-compound formulation calcipotriol and betamethasone dipropionate gel in the treatment of moderately severe scalp psoriasis: a systematic review of direct and indirect evidence. Curr. Med. Res. Opin. 2011;27(1):251-68.
  16. Fleming C., Ganslandt C., Guenther L., et al. Calcipotriol plus betamethasone dipropionate gel compared with its active components in the same vehicle and the vehicle alone in the treatment of psoriasis vulgaris: a randomised, parallel group, double-blind, exploratory study. Eur. J. Dermatol. 2010;20(4):465-71.
  17. Sticherling M., Eicke C., Anger T. Practicability of combined treatment with calcipotriol/ betamethasone gel (Daivobet(R) Gel) and improvement of quality of life in patients with psoriasis. J. Dtsch. Dermatol. Ges. 2013;11(5):420-27.
  18. Reich K., Bewley A. What is new in topical therapy for psoriasis? J. Eur. Acad. Dermatol. Venereol. 2011;25(Suppl. 4):15-20.
  19. Fleming C., Ganslandt C., Guenther L., et al. Calcipotriol plus betamethasone dipropionate gel compared with its active components in the same vehicle and the vehicle alone in the treatment of psoriasis vulgaris: a randomised, parallel group, double-blind, exploratory study Eur. J. Dermatol. 2010;20(4):465-71.
  20. Augustin M., Radtke M., van Engen A., et al. Pharmacoeconomic model of topical treatment options of mild to moderate psoriasis vulgaris in Germany. J. Dtsch. Dermatol. Ges. 2009;7(4):329-38.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies