The efficacy of combination treatment with narrowband UVB (TL-01) and acitretin vs narrowband UVB alone in plaque-type psoriasis: a retrospective study.

BACKGROUND: NarrowBand Ultra Violet B phototherapy (NB-UVB) is a highly effective therapeutic modality for plaque-type psoriasis, however several hospital visits are often required. Oral acitretin is moderately effective as monotherapy, but when combined with phototherapy, its use has reduced the number of treatments required for clearing. There is only sparse data on the combination of acitretin with NB-UVB. MATERIAL AND METHOD: Twenty nine patients with plaque-type psoriasis who were treated with NB- UVB alone or in combination with acitretin were retrospectively analyzed for treatment outcome in terms of total numbers and cumulative doses of narrowband UVB treatments. Of these, nine had the combination while 20 received NB-UVB alone. RESULTS: The combination of low dose acitretin (25 mg/day) and NB-UVB resulted in marked improvement of patients. The numbers of irradiation, final doses and cumulative doses of NB-UVB were lower albeit not statistically significant in the combination group. The combination was well tolerated and associated with typical retinoid and NB-UVB side effects. CONCLUSION: The combination treatment with acitretin and NB-UVB in plaque-type psoriasis has more therapeutic advantages than phototherapy alone.

Drug eruptions at five institutes in Bangkok.

The study was performed in five hospitals in Bangkok for a period of one year. All in- and outpatients who developed drug eruption from January to December 2001 were enrolled into the study. Physical examinations and complete history-taking were performed by one of the authors. A skin biopsy was done to confirm the diagnosis in every suspected case. Oral challenge test was performed to obtain a definite diagnosis only in some patients with informed consent. Among 212 patients, the most common causative drugs were antimicrobial agents with cephalosporin group in the highest rank. Maculopapular rash was the most common type of drug eruption followed by urticaria and photosensitivity reaction. It was concluded that antimicrobial agents were the predominant causative agents and maculopapular eruption was the most frequent clinical manifestation. New kinds of antimicrobial agents, anti-inflammatory drugs and lipid lowering agents could cause various patterns of drug eruption.

Comparative study of the efficacy of topical corticosteroid: five locally made and one brand name creams.

The aim of this study was to evaluate the efficacy of 5 locally made clobetasol propionate creams compared with a brand name product. The study was divided into 3 parts 1) pharmacological study, 2) vasoconstriction test, and 3) double blind clinical trial. The results showed that the pharmacological properties of the locally made products were not different from the brand name product. Product C and D could diffuse through cellulose acetate membrane 3 fold more than the brand name product. Product D and E caused less vasoconstriction than the brand name product. This double blind study showed that all locally made products could improve psoriasis to the same extent as the brand name product, but there was more recurrence of psoriasis while using all the locally made products. It was concluded that locally made products were as effective as the brand name product in the treatment of psoriasis evaluated over a 2 week peroid, but more recurrence was observed with locally made products.