Usefulness of Sequential Topical Therapy with Calcipotriol Ointment and Betamethasone Butyrate Propionate Ointment in Patients with Psoriasis Vulgaris

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  • KUBOTA Yasuo
    Department of Dermatology, Faculty of Medicine, Kagawa University
  • MORIUE Tetsuya
    Department of Dermatology, Faculty of Medicine, Kagawa University
  • NAKAI Kozo
    Department of Dermatology, Faculty of Medicine, Kagawa University
  • YOKOI Ikumi
    Department of Dermatology, Faculty of Medicine, Kagawa University
  • FUJITA Natsuko
    Department of Dermatology, Faculty of Medicine, Kagawa University
  • MUNEHIRO Asuka
    Department of Dermatology, Faculty of Medicine, Kagawa University
  • MORIUE Junko
    Department of Dermatology, Faculty of Medicine, Kagawa University
  • YONEDA Kozo
    Department of Dermatology, Faculty of Medicine, Kagawa University

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Other Title
  • 尋常性乾癬に対するカルシポトリオール軟膏およびベタメタゾン酪酸エステルプロピオン酸エステル軟膏による外用連続療法の有用性
  • ジンジョウセイカンセン ニ タイスル カルシポトリオール ナンコウ オヨビ ベタメタゾンラクサン エステルプロピオンサン エステル ナンコウ ニ ヨル ガイヨウ レンゾク リョウホウ ノ ユウヨウセイ

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We performed sequential topical therapy with calcipotriol ointment (Dovonex® Ointment 0.005%) and betamethasone butyrate propionate ointment (Antebate® Ointment 0.05%) for 9 weeks in 19 patients with psoriasis vulgaris (PS) to assess the clinical usefulness of this therapy in terms of the symptom score and quality of life (QOL). During the induction phase of the sequential topical therapy, both drugs were applied twice daily for a two to four-week period. During the following transitional phase, calcipotriol ointment alone was applied on weekdays, while both of these drugs were applied twice daily on weekends for an additional two to four weeks. During the maintenance phase, calcipotriol ointment alone was applied for another two to four weeks. Skin symptoms were assessed using the score of the modified psoriasis area and severity index (PASI) scoring system, which excludes assessment of the face and head from the PASI scoring system, and a visual analog scale (VAS) score reported by the subjects. QOL in PS patients was assessed using the Dermatology Life Quality Index (DLQI Japanese version). The mean modified PASI score was 20.2 at baseline, was reduced by 60% to 8.1 on completion of the induction phase (P<0.01), and subsequently decreased over time to 4.4 on completion of the maintenance phase (a 78% decrease from baseline, P<0.01). The severity of skin lesions and itching measured by VAS also decreased significantly. Total DLQI score was 9.2 at baseline, and was reduced to 3.1 at the completion of observation (P<0.01) ; in particular, the aspects of symptoms and feelings, daily activities, and leisure were significantly improved (P<0.01). Neither local irritation nor abnormal changes in serum calcium levels were noted. The present study suggested that this sequential topical therapy for psoriasis vulgaris promptly improved skin symptoms, subsequently provided long-term remission, and improved QOL in terms of mentality, daily activities, and behavior.

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