ABSTRACT
Objective:To evaluate short-term efficacy and safety of fluticasone propionate 0.05% cream alone or in combination with calcipotriol 0.005% ointment in the treatment of mild to moderate plaque psoriasis.Methods:From October 2020 to January 2021, a randomized, open-labeled, self-controlled clinical trial was conducted among 30 patients with mild to moderate plaque psoriasis in Beijing Friendship Hospital. Skin lesions on the extremity of one side were topically treated with calcipotriol 0.005% ointment in the morning and fluticasone propionate 0.05% cream in the evening (combination group) , and lesions on the contralateral extremity were topically treated with fluticasone propionate 0.05% cream twice a day (fluticasone propionate group) . The treatment lasted 4 weeks. Before and 1, 2, 4 weeks after the start of treatment, the patients were followed up, clinical indices including static physician′s global assessment (sPGA) and psoriasis area and severity index (PASI) were evaluated, and adverse events were recorded. Efficacy and safety were evaluated by using repeated measures analysis of variance, multivariate analysis of variance, Mann-Whitney rank sum test and two-independent-sample t test. Results:Before the treatment, there was no significant difference in sPGA or PASI score between the combination group and fluticasone propionate group (both P > 0.05) . After 1-week treatment, the fluticasone propionate group showed significantly decreased sPGA (1.10 ± 0.31 points) and PASI scores (1.05 ± 0.51 points) compared with the combination group (1.73 ± 0.45 points, 1.38 ± 0.69 points, F= 40.74, 4.38, respectively, both P < 0.05) ; after 2- and 4-week treatment, the combination group showed significantly decreased sPGA (0.83 ± 0.46 points, 0.23 ± 0.43 points, respectively) and PASI scores (0.53 ± 0.47 points, 0.23 ± 0.50 points, respectively) compared with the fluticasone propionate group (sPGA: 1.03 ± 0.18 points, 0.97 ± 0.32 points, F= 4.88, 56.14, respectively, both P < 0.05; PASI: 1.03 ± 0.51 points, 0.92 ± 0.54 points, F= 15.20, 26.36, respectively, both P < 0.05) . After 1-week treatment, the infiltration/hypertrophy severity score was significantly lower in the fluticasone propionate group than in the combination group ( U= 165.00, P < 0.05) ; after 2- and 4-week treatment, the erythema and scaling severity scores were significantly lower in the combination group than in the fluticasone propionate group (erythema: U= 540.00, 765.00, respectively, both P < 0.05; scaling: U= 825.00, 795.00, respectively, both P < 0.05) . Conclusion:Fluticasone propionate 0.05% cream alone exhibited a rapid onset of efficacy in the treatment of psoriasis, while fluticasone propionate 0.05% cream combined with calcipotriol 0.005% ointment was more effective after 2- and 4-week treatment, and both regimens showed a favorable safety profile.
ABSTRACT
OBJECTIVE@#To observe the short-term and long-term effects of moxibustion on plaque psoriasis of blood stasis, and to compare the curative effect between moxibustion and calcipotriol ointment.@*METHODS@#A total of 80 patients with plaque psoriasis of blood stasis were randomly divided into an observation group (40 cases, 2 cases dropped off) and a control group (40 cases, 4 cases dropped off). Both groups were given routine medical vaseline topical emollient basic treatment. In the observation group, moxibustion was applied to @*RESULTS@#After treatment, the PASI scores in the both groups were lower than before treatment (@*CONCLUSION@#Both moxibustion and calcipotriol ointment have good short-term effects on plaque psoriasis of blood stasis. Moxibustion has more advantages in reducing the recurrence rate of psoriasis, improving the main clinical symptoms of TCM and quality of life.
Subject(s)
Humans , Acupuncture Points , Moxibustion , Psoriasis/drug therapy , Quality of Life , Treatment OutcomeABSTRACT
Clobetasol propionate is an internationally accepted common name for 21-chloro-9-fluoro-11beta,17-dihydroxy16beta-methylpregna-1,4-diene-3,20-dione 17-propionate. The combination of calcipotriol (vitamin D3 analogue) andclobetasol propionate (super potent steroid) is being used as a topical formulation for the treatment of psoriasis fromseveral years. In this work, an ultra-high performance liquid chromatography equipped with photodiode array detectorand a mass compatible mobile phase in a gradient elution is employed for the separation of five related substancesin presence of calcipotriol and its two impurities with a last eluting impurity in less than 11 minutes. A simple andefficient sample extraction procedure was developed to achieve the highest sensitivity as of today with limit of detectionand limit of quantitation of 0.03% and 0.10%, respectively, as required by industry for drug product of clobetasolpropionate and its combination products. Stationary phase with fused core particle technology is employed for theseparation of impurities. Precision of the method is found to be less than 1.0% Relative standard deviation (RSD). Thecorrelation coefficient is >0.999. Accuracy of method is ranged from 93.3% to 108.0%. This is the first reported Ultrahigh performance liquid chromatography (UHPLC) method for the estimation of five related substances of clobetasolpropionate in its combination product with calcipotriol.
ABSTRACT
Background: Topical calcitriol and calcipotriol, the two vitamin D derivatives although considered efficient in treating psoriasis, their comparative studies are relatively scanty. The objective of the present study was to evaluate and compare the efficacy and safety of calcitriol and calcipotriol in stable chronic plaque-type psoriasis.Methods: Total 50 patients of chronic stable plaque-type psoriasis were randomly divided into two groups of 25 each. One group received calcitriol 3礸/g ointment and the other group received calcipotriol 50礸/g ointment twice daily for 12 weeks. Efficacy evaluations comprised global improvement (on a 4-point scale from 0: no change, to 3: clear or almost clear) assessed clinically and by the subject. Efficacy further included the 慸ermatological sum score� (DSS) at each study visit. Safety evaluations (on a 5-point scale from 0: none, to 4: very severe) included clinical assessment of cutaneous safety and assessment of cutaneous discomfort by the subject.Results: Both calcitriol and calcipotriol were significantly effective (p <0.001) in reduction of DSS but the difference between the two groups was not statistically significant. Mean score of global improvement assessed clinically was 2.20 for calcitriol and 2.16 for calcipotriol (p >0.05) and by the subject was 1.92 for calcitriol and 1.84 for calcipotriol (p >0.05). The difference between the two groups was not statistically significant. The mean worst score for cutaneous safety was higher in calcipotriol group compared to calcitriol group (0.28 vs 0.04 and 0.36 vs 0.04 by clinically and by the subject, respectively). Statistically significant better safety profile (p <0.05) was seen for calcitriol, only when assessed by the subject. 24% treatment related adverse events were reported with calcipotriol against only 4% with calcitriol.Conclusions: Topical calcitriol and calcipotriol showed similar efficacy in the treatment of chronic plaque psoriasis while calcitriol showed better safety profile in comparison with calcipotriol, in terms of local tolerance and induced less treatment related adverse events.
ABSTRACT
Objective To explore a method for rapidly establishing a mouse model of atopic dermatitis (AD).Methods C57BL/6 mice served as model animals,and were randomly divided into 3 groups:calcipotriol + ovalbumin (OVA) group (n =6) topically treated with calcipotriol and OVA on the mouse ears,calcipotriol group (n =6) topically treated with calcipotriol on the ears,and control group (n =3) topically treated with 75％ alcohol on the ears.The treatment lasted 12 days.Before the model establishment and on day 14,the photos of the mouse ears were taken,and ear thickness was measured;moreover,blood samples were obtained from the mouse caudal vein,and serum levels of total IgE and OVAspecific IgE were detected.On day 14,the skin tissues of mouse auricles were resected and subjected to histopathological examination.Results On day 14,erythematous swelling,dryness and desquamation occurred on the mouse ear skin in the calcipotriol + OVA group and calcipotriol group,and both the two groups showed significantly increased ear thickness compared with those before the model establishment (both P ＜ 0.001).However,there was no significant difference in the ear thickness between the calcipotriol + OVA group (0.355 ± 0.03 mm) and calcipotriol group (0.370 ± 0.05 mm,q =0.674,P =0.231).Histopathological examination of the ear skin showed more obvious epidermal hyperplasia and infiltration of dermal inflammatory cells including eosinophils and mastocytes in the calcipotriol + OVA group compared with the calcipotriol group and control group.Immunohistochemical study revealed that there was no significant difference in the expression of thymic stromal lymphopoietin (TSLP) and interferon (IFN)-γ among the 3 groups (both P ＞ 0.05),while the expression of interleukin (IL)-13 significantly differed among the 3 groups (F =5.159,P =0.032),and was significantly higher in the calcipotriol + OVA group (77.12 ± 5.46) than in the control group (55.49 ± 9.92,q =3.170,P =0.021).On day 14,the calcipotriol + OVA group and calcipotriol group both showed markedly increased total serum IgE levels compared with those before the treatment,and the calcipotriol + OVA group showed a more significant increase (8 278.56 ± 3 297.68 vs.892.64 ± 82.83 μ g/L,t =4.132,P =0.026).Meanwhile,the serum level of OVA-specific IgE was significandy higher in the calcipotriol + OVA group (192.846 ± 15.391 μg/L) than in the calcipotriol group (8.492 ±:3.879 μg/L,q =22.476,P ＜ 0.001) on day 14.Conclusion The mouse model of allergeninduced AD can be rapidly established by topical application of calcipotriol and OVA for 12 consecutive days,which lays a foundation for further study on allergen-related pathogenesis of AD.
ABSTRACT
Objective To evaluate the effect of pretreatment with calcipotriol on protoporphyrin Ⅸ (PpIX) content in the normal epithelium of nude mice after topical application of aminolevulinic acid (ALA).Methods A total of 36 BALB/C nude mice were randomly and equally divided into 2 groups:calcipotriol + ALA group topically pretreated with calcipotriol ointment for 3 days followed by topical application of ALA,and ALA group topically treated with ALA alone.At 2,3,4,5,6 and 7 hours after ALA application,3 mice in each group were sacrificed separately,and skin tissues were obtained from the experimental region in the back of mice.A fluorospectrophotometer was used to detect the PpIX content in the normal epithelial tissue of the nude mice,and an inverted fluorescence phase-contrast microscope to observe the fluorescence intensity and distribution of PpIX in the frozen sections of epithelial tissues.Results During 2-8 hours after topical application of ALA,the content of PpIX in the skin tissues of nude mice in the two groups gradually increased over time.Correlation analysis revealed no correlations between the PpIX content in the ALA group and the treatment duration (r =0.451,P =0.369),while the PpIX content in the calcipotriol + ALA group was strongly correlated with the treatment duration (r =0.913,P =0.011).The PpIX content in the ALA group reached a peak at 5 hours [(461.24 ± 43.45) ng/g tissues],while the PpIX content in the calcipotriol + ALA group peaked at 6 hours [(668.88 ± 42.46) ng/g tissues].At 2,3,4,5,6 and 7 hours after ALA application,the PpIX content was significantly higher in the calcipotriol + ALA group than in the ALA group (P ＜ 0.05 or 0.01).Frozen-section examination showed that PpIX was diffusely distributed in the epidermis and dermis of the nude mice,and the fluorescence intensity of PpIX was higher in the calcipotriol + ALA group than in the ALA group at 5,6 and 7 hours after ALA application.Conclusion Pretreatment with calcipotriol can increase the content of PpIX in the normal epidermis and dermis of nude mice after topical application of ALA,which provides a theoretical basis for the clinical application of calcipotriol as a local synergist of ALA-PDT.
ABSTRACT
Objective: To develop a new method for the determination of calcipotriol ointment by high-speed counter-current chro-matography(HSCCC). Methods: An HSCCC method was used coupled with two-phase solvent system consisting of petroleum benzine-ethanol -water(2: 1: 0. 5, v/v/v). The injection volume was 1. 0 ml and the detection wavelength was set at 265 nm. Results: The proposed method showed good linearity within the range of 4.02-40.20 μg·ml-1(r=0.999 4). The average recovery was 99.2%, and the RSD was 0. 4% (n=9) . Conclusion: The HSCCC method is simple and rapid, and suitable for the determination of calcipo-triol ointment.
ABSTRACT
Objective To investigate clinical efficacy of the NB-UVB phototherapy combined with calcipotriol ointment and halometasone cream in the treatment of psoriasis.Methods 90 patients with psoriasis were selected and randomly divided into control group and observation group with 45 cases of patients.In both two groups,calcipotriol ointment,1 time/d,were used combined with halometasone cream,1 time/d,with a total of 4 weeks.On the basis of these,patients of observation group were added NB-UVB phototherapy (Germany Waldmann7001K ultraviolet light therapy device),1 time every other day with starting dose of 0.5J/cm2,each increment of 0.1J/cm2,for treatment of 15 times.Before and after treatment in patients of two groups,PASI score and clinical efficacy were observed.Visual analogue scale (VAS) were was used to observe itching skin lesions before and after treatment.By using Dermatology Life Quality Index (DLQI),qualities of life in two groups of patients before and after treatment were evaluated.observe two patients before and after treatment expression levels of serum IL-17A,IL-22 and IL-1βwere also observed in patients of the two groups.Results The total efficiency of the observation group was 88.89％,which of the control group was 80.00％,the clinical efficacy of the observation group which was higher than that of the control group,and the difference was statistically significant (x2 =5.23,P ＜ 0.05).Before treatment,the difference of PASI,VAS score and DLQI in the two groups of patients were not statistically significant (P ＞ 0.05).After treatment,scores in the two groups of patients were significantly decreased,and the degree of decrease in the observation group was higher than the control group,the difference was significant (P ＜ 0.05).Before treatment,the differences in serum IL -17A,IL-22 and IL-1β expression levels of both two groups were not statistically significant (P ＞0.05).After treatment,these expression levels of the two groups of patients decreased significantly,and the decreased of observation group was more significantly than that of the control group (P ＜ 0.05).Conclusion NB-UVB phototherapy combined with calcipotriol ointment and halometasone cream in treatment of psoriasis vulgaris patients can significantly improve patients' skin lesions,and can improve patients' quality of life score,which is worthy of promotion.
ABSTRACT
Objective To investigate the effect of calcipotriol in the treatment of psoriasis vulgaris.Methods 306 patients with stable psoriasis vulgaris were randomly divided into control group (n =153) and experimental group (n =153).Patients received in 2 groups received Vitamin C,folic acid and narrow-band UVB treatment.The control group was treated with clobetasol propionate ointment,those and in the experimental group was treated with topical ointment of calcipotriol.Scores of PASI and dermatological quality of life (DLQI)were measured,and the therapeutic effect,the serum levels of inflammatory cytokines,T lymphocyte subpopulations and skin barrier function were compared between the two groups.Results Compared with before treatment,levels of IFN-γ,IL-2,IL-17 and IL-18 in the two groups decreased (P ＜ 0.01),levels of CD3 +,CD4 + and CD4 +/CD8 + increased (P ＜ 0.01),levels of CD8 + decreased (P ＜0.01),levels of sebum content,water content of cuticle increased (P ＜ 0.01),levels of PH value decreased (P ＜ 0.01),PASI score,DLQI score decreased (P ＜ 0.01).Compared with the control group,the levels of IFN-γ,IL-2,IL-17 and IL-18 were lower (P ＜ 0.01),levels of CD3 +,CD4 + and CD4 +/CD8 + were higher (P ＜0.01),levels of CD8 + was lower(P ＜0.01),sebum content,water content of cuticle were higher (P ＜ 0.01),PH value was lower(P ＜0.01),PASI score and DLQI score were lower(P ＜0.01).Conclusion The efficacy of calcipotriol in treating psoriasis vulgaris is significant,worth of clinical promotion.
ABSTRACT
Objective To investigate association of vitamin D receptor (VDR) polymorphisms with susceptibility to psoriasis vulgaris and clinical response to calcipotriol in patients with psoriasis vulgaris.Methods A total of 110 patients with psoriasis vulgaris and 183 healthy controls were enrolled into this study,and they were all of Han nationality from Hainan province.Ligase detection reaction (LDR) was conducted to determine the genotypes of VDR gene polymorphisms rs2228570,rs731236,rs1544410 and rs7975232.Single nucleotide polymorphism (SNP)-based association analysis in genotypic and allelic models,and haplotype-based association analysis were then performed.Then,75 patients with psoriasis area and severity index (PASI) scores less than 10 were topically treated with calcipotriol ointment alone.After 6-week treatment,the efficacy of calcipotriol ointment was evaluated,and the correlation between the efficacy and individual genotypes was analyzed.Results The frequency of A allele of rs7975232 in the psoriasis group and control group was 39.09％ and 27.05％ respectively,and the risk of developing psoriasis in rs7975232 A allele carriers was significantly higher than that in non-carriers (OR =1.731,95％ CI:1.213-2.471,P ＜ 0.05).Additionally,the risk of developing psoriasis in individuals with AA genotype (OR =2.404,95％ CI:1.085-5.328,P ＜ 0.05),as well as in individuals with AC genotype (OR =2.143,95％ CI:1.283-3.579,P ＜ 0.05),was significantly higher than that in patients with CC genotype.CTGA haplotype carriers (rs2228570,rs731236,rs1544410,rs7975232,respectively) had significantly higher risk of developing psoriasis compared with non-carriers (OR =1.907,95％ CI:1.132-3.214,P ＜ 0.05).Among 72 patients with mild-to-moderate psoriasis whose PASI scores were less than 10,patients with CC genotype of rs7975232 showed better response to calcipotriol ointment compared with those with AC genotype (OR =3.798,95％ CI:1.061-13.590,P ＜ 0.05) and those with AA genotype (OR =9.667,95％CI:1.556-60.040,P ＜ 0.05).Conclusion VDR polymorphisms are associated with psoriasis susceptibility and clinical response to calcipotriol in patients with psoriasis individuals.
ABSTRACT
Topical calcipotriol/betamethasone dipropionate ointment/gel has been commonly used for the treatment of psoriasis vulgaris. However, the effi cacy of this combination needs to be consolidated. We aimed to assess the effects and safety profi le of calcipotriol/ betamethasone dipropionate for the treatment of psoriasis vulgaris, using evidence based approach. Randomized controlled trials on the treatment of psoriasis vulgaris with calcipotriol/ betamethasone dipropionate were identifi ed by searching PubMed, China National Knowledge Infrastructure and the Cochrane Library. The primary outcome measure was the Psoriasis Area and Severity Index (PASI) score. Ten randomized controlled trials involving 6590 participants were included. The methodologies of the studies were generally of moderate to high quality. These trials used topical calcipotriol/betamethasone dipropionate for 4 or 8 weeks, and were compared with topical calcipotriol or betamethasone. The results showed that calcipotriol/betamethasone dipropionate was more effective than controls. A four-week treatment with calcipotriol/betamethasone dipropionate did not show any signifi cant difference between the once-daily or twice-daily regimen. The adverse events of calcipotriol/betamethasone dipropionate were tolerable and acceptable. The reports included in this review are heterogenous and have limitations. Topical application of calcipotriol/ betamethasone dipropionate once daily is an effi cacious treatment for psoriasis vulgaris and is associated with few side effects.
ABSTRACT
La morfea ampollosa es un tipo infrecuente de morfea, por esta razón existe poca evidencia en la literatura acerca del mejor tratamiento para esta patología. Presentamos el caso de una niña de 10 años a quien se le realizó un diagnóstico de morfea ampollosa, y fue tratada exitosamente con fototerapia UVA-1, calcipotriol y superóxido dismutasa.
Bullous morphea is an infrequent type of morphea, for this reason there is not much evidence on the literature about the best treatment for this condition. We introduce the case of a 10 years old child with a bullous morphea diagnosis; she was successfully treated with phototherapy, calcipotriene and superoxide dismutase.
Morfea bolhosa é um tipo de morphea infreqüente, por isso não há muita evidência na literatura sobre o melhor tratamento para esta condição. Apresentamos o caso de uma criança de 10 anos com diagnóstico de morféia bolhosa; Ela foi tratada com sucesso com fototerapia, calcipotriol e superóxido-dismutase.
Subject(s)
Humans , Female , Child , Scleroderma, Localized , Phototherapy , Superoxide DismutaseABSTRACT
Aim To investigate the method of establishing the atopic dermatitis mice model induced by calcipotriol ( MC903 ) . Methods Induction dose exploratory experiment: since d 0, 0.33,1,3 nmol MC903 was smeared on the right ear of BALB/c mice in each dose group respectively , for 7 consecutive days . The ear swelling degree of the mice was observed every day and the bilateral ears thicknesses were measured .The materials were drawn and analyzed in d 3 and d 7.Induction days exploratory experiment: 2 nmol MC903 was smeared on the right ear of BALB/c mice, for 14 consecutive days .The ear swelling degree of mice was observed every day and the bilateral ears thicknesses were measured .The histopathological examination of the right ear was conducted in 3 d, 7 d, 11 d and 15 d respectively .The tissue homogenate of the mice right ear was prepared .The ex-pressions of thymic stromal lymphopoietin (TSLP),IL-33, IL-4 and IFN-γin the homogenate , CD40 +,CD86 +,the DC surface markers and ILC2 contents in the peripheral lymph nodes were detected.Results ①1,3 nmol MC903 induced ear swelling in mice was significantly increased in d 3, the levels of TSLP and IL-4 were significantly increased .The level of IL-33 in 3 nmol dose group was increased significantly in d 7.② The right ear swelling of 2 nmol MC903 induced atopic dermatitis mice was significant , the ear thickness was increased gradually and reached the peak in d 14.The histopathological examination of the mice ear tissue showed in d 7, the right ear tissue of the mice was swelling and red , the capillary vessels were dilated and the infiltration of inflammatory cells was obvious .The ear in-flammatory symptoms maintained and gradually aggravated for 15 days.Compared with the normal mice , MC903 increased the TSLP level in the right ear tissue homogenate significantly in d 3 and then decreased gradually .The levels of IL-4 and IL-33 were increased significantly in d 7 and then decreased gradually .The levels of ILC2, CD40 +, CD86 + in the peripheral lymph nodes were increased in d 7 and d 15.Conclusion The atopic derma-titis mice model can be successfully established using 2 nmol MC903 induced mice for 7 days.Appropriate testing point of TSLP is d 3.Appropriate testing point of IL-33 and IL-4 is d 7.
ABSTRACT
OBJECTIVE:To observe therapeutic efficacy and safety of Calcipotriol betamethasone ointment combined with Compound glycyrrhizin injection in the treatment of erythrodermic psoriasis. METHODS:120 cases of erythrodermic psoriasis were randomly divided into observation group and control group,60 cases in each. Control group received Calcipotriol betamethasone ointment topical,2 times a day,for 6 weeks. Observation group was additionally given Compound glycyrrhizin injection 80 ml add-ed into 250 ml Glucose solution intravenously,once a day,on the basis of control group. PASI score,VAS score,DLQI score, Clinical efficacy and ADR of 2 groups were observed. RESULTS:Two groups of patients after treatment,PASI score,VAS score, lesion area and DLQI score were significantly decreased,the observation group decreased more significantly,the difference was sta-tistically significant (P0.05). CONCLUSIONS:Calcipotriol betamethasone ointment combined with Compound glycyrrhizin injection can effectively alleviate the clinical symptoms of psoriasis erythrodermic,improve their quality of life,has a definite curative effect and ADR.
ABSTRACT
BACKGROUND: Despite efforts to treat trachyonychia, there is no promising treatment modality. OBJECTIVE: This study evaluated the efficacy and safety of calcipotriol plus betamethasone dipropionate ointment on trachyonychia. METHODS: A total of 39 patients with 432 nails affected by trachyonychia were enrolled. All patients applied calcipotriol/betamethasone ointment once daily without occlusion for 6 months. Outcome measures were assessed by physician's global assessment (degree of roughness: 0, clear; 1, mild; 2, moderate; 3, marked; 4, severe) at all time points. RESULTS: After 6 months of therapy, 98.6% (426/432) of nails showed significant clinical improvement; 4.2% were completely free from nail lesions. The mean physician global assessment score decreased significantly from 3.5 to 1.7 points (p< 0.05). No serious side effects were reported, except mild pruritus and erythema in 2 patients. CONCLUSION: This is the first study to prospectively evaluate the efficacy and safety of calcipotriol/betamethasone ointment for the treatment of trachyonychia. The results indicate topical calcipotriol/betamethasone is an effective and safe treatment for symptom improvement of trachyonychia.
Subject(s)
Humans , Betamethasone , Erythema , Outcome Assessment, Health Care , Prospective Studies , Pruritus , PsoriasisABSTRACT
BACKGROUND: In the treatment of vitiligo, topical corticosteroids are known to be effective, but are associated with serious adverse effects. Many studies have shown that topical calcipotriol is a promising therapeutic modality in vitiligo. In some studies, combined calcipotriol and betamethasone dipropionate ointment has been shown to be a more effective and well tolerated treatment for vitiligo. The combination therapy seems to synergistically act as an immunosuppressive and a pigment restorative agent. OBJECTIVE: We investigated the clinical efficacy of CCB (Combination Calcipotriol and Betamethasone dipropionate) gel compared with that of betamethasone dipropionate alone in the repigmentation of vitiligo. METHODS: In an intraindividual right-left comparison study (n=20), a CCB gel was applied once daily to a lesion on one side, and betamethasone dipropionate cream was applied to a lesion on the other side. The degree of repigmentation was assessed according to the Vitiligo Area Scoring Index (VASI) at baseline, 4, 12, 24, and 48 weeks. RESULTS: The CCB gel treated group showed a remarkably improved therapeutic outcome compared to the betamethasone dipropionate monotherapy group: the percentages of VASI relative to the baseline at CCB gel treated sites were 82.73+/-8.17%, 70.45+/-14.05%, 62.73+/-17.52%, and 56.24+/-18.49% at 4, 12, 24, and 48 weeks after treatment, respectively; while those of the other sites receiving betamethasone dipropionate were 89.55+/-7.24%, 84.55+/-10.60%, 77.73+/-14.38%, and 73.48+/-12.93%. Adverse effects such as atrophy and burning sensations were much less after CCB gel treatment than after betamethasone monotherapy. CONCLUSION: CCB gel is more effective and tolerable than betamethasone dipropionate monotherapy in repigmentation therapy for vitiligo.
Subject(s)
Adrenal Cortex Hormones , Atrophy , Betamethasone , Burns , Sensation , VitiligoABSTRACT
Objective To observe the clinical efficacy and safety of calcipotriol betamethasone ointment for the treatment of pso‐riasis vulgaris in the stable stage of patient .Methods This was a randomized ,parallel controlled clinical trials ,in which 90 patients with psoriasis vulgaris were randomly divided into experimental group and controlled group .All of them received 4 weeks of thera‐py .We compared the efficacy and safety 1 ,2 ,4 week after treatment by calcipotriol betamethasone ointment .Results About the clinical efficacy ,according to the decrease in percentage of psoriasis area and severity index (PASI) were:23 patients in the experi‐mental group were effective(efficacy rate is 76 .67% ) ,14 patients in control group Ⅰ was effective(efficacy rate is 46 .67% ) ,15 pa‐tients in control group Ⅱ was effective(efficacy rate is 50% ) .The differention between experimental group and the two control groups was significant(P< 0 .05 ,P< 0 .01) .After 1 ,2 ,4 weeks of therapy ,the decrease in percentage of PASI of experimental group is higher than that in the control groups .The scores of the observed erythema ,infiltration ,scale were decreased ,and the total scores of PASI are also decreased 4 weeks after therapy .The decrease score of experimental group is higher than that of control group Ⅰ(P<0 .01) and control group Ⅱ(P<0 .01) .The side effects of the experimental group are mild such as itching ,folliculi‐tis ,erythema ,and the laboratory examinations had no abnormal changes .Conclusion Calcipotriol betamethasone ointment was more effective to treat the stable stage psoriasis vulgaris patients compared with single use of halometasone or calcipotriol .It takes effect quickly ,and could be more feasible and safe .
ABSTRACT
Objective To evaluate the effect of calcipotriol on the proliferation of and cytokine secretion by melanocytes and perilesional CD8+ cytotoxic T lymphocytes (CTLs) from patients with vitiligo.Methods Melanocytes isolated from abdominal skin and CD8+ CTLs from perilesional skin of patients with vitiligo were subjected to successive culture in vitro.After several passages,the melanocytes and CD8+ CTLs were cultured alone or in combination with or without the presence of various concentrations of calcipotriol for 24 to 48 hours.MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfopheny)-2H-tetrazolium,inner salt) method was used to evaluate the proliferative activity of cells,enzyme-linked immunosorbent assay to determine the levels of interleukin (IL)-6,tumor necrosis factor (TNF)-α and interferon (IFN)-γ in the culture supematant of cells,flow cytometry to detect cell apoptosis.Some co-cultured melanocytes and CTLs were treated with calcipotriol of 10-8 mol/L and anti-IL-6 antibody of various concentrations (0,1,2,2.5,5,10 mg/L) for two days followed by enumeration of cells.The concentrations of 108 and 10-9 mol/L (calcipotriol) were chosen for relevant tests.Results There was a marked apoptosis in MCs after coculture with CD8+ CTLs.The 24-hour treatment with calcipotriol of 104 and 10-9 mol/L had no obvious effect on the proliferation of melanocytes cultured alone (both P ＞ 0.05),but accelerated the proliferation of melanocytes cocultured with CTLs (both P ＜0.05) as well as that of CD8+ CTLs cultured alone or in combination with melanocytes (all P ＜0.05).A statistical decrease was observed in IL-6,TNF-α and IFN-γlevels in the supernatant of cocultured melanocytes and CTLs compared with those in the supernatant of melanocytes and CTLs cultured alone,and calcipotriol of 10-9 mol/L intensified the decrease in supernatant IL-6 level (t =2.89,P ＜0.05),but no statistical changes were noted for the level of TNF-α or IFN-γin the supernatant of the coculture system after treatment with calcipotriol of 104 or 104 mol/L compared with that before treatment (both P ＞ 0.05).In the coculture system pretreated with calcipotriol of 10-8 mol/L,the number of CD8+ CTLs significantly decreased (t =3.15,P ＜0.05),whereas that of melanocytes significantly increased (t =3.53,P ＜0.05) after the treatment with anti-IL-6 antibody of 5 mg/L.Conclusions Perilesional CD8+ CTLs have a specific cytotoxic effect on melanocytes,and calcipotriol may inhibit the cytotoxic effect of CD8+ CTLs by suppressing the secretion of IL-6,which may partly explain the therapeutic mechanism of calcipotriol for vitiligo.
ABSTRACT
Inflammatory linear verrucous epidermal nevi (ILVEN) were first described in the literature, in 1971, by Altman and Mehregan. Most cases were reported as solitary lesions. In contrast, systematized ILVEN, involving wide areas of the integument, has only rarely been reported. A variety of treatment modalities has been reported, ranging from topical medications, such as potent corticosteroids or tretinoin 0.1% to variable procedures, including CO2 and pulsed dye laser, cryotherapy, and surgical excision. However, multifocal skin lesion is more difficult to treat. An 8-year old boy was presented with an extensive thick scaly plaques and patches, affecting the trunk and the four extremities sparing face. It developed when he was 3 years old, and he complained pruritus. On physical examination, linear, or whirl-like scaly plaques were seen, along with Blaschko lines. Pathologic finding was in accordance to ILVEN. We treated him with topical calcipotriol, tacrolimus and systemic acitretin. After 8 months, the lesion and symptoms improved.
Subject(s)
Acitretin , Adrenal Cortex Hormones , Calcitriol , Cryotherapy , Extremities , Lasers, Dye , Nevus , Nevus, Sebaceous of Jadassohn , Physical Examination , Pruritus , Skin , Tacrolimus , TretinoinABSTRACT
Alopecia areata (AA) is an inflammatory hair loss of unknown etiology. AA is chronic and relapsing, and no effective cure or preventive treatment has been established. Vitamin D was recently reported to be important in cutaneous immune modulation as well as calcium regulation and bone metabolism. It is well known that areata is common clinical finding in patients with vitamin D deficiency, vitamin D-resistant rickets, or vitamin D receptor (VDR) mutation. The biological actions of vitamin D3 derivatives include regulation of epidermal cell proliferation and differentiation and modulation of cytokine production. These effects might explain the efficacy of vitamin D3 derivatives for treating AA. In this study, we report a 7-year-old boy with reduced VDR expression in AA, recovery of whom was observed by topical application of calcipotriol, a strong vitamin D analog.