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[Objective] To investigate the clinical efficacy of tacalcitol combined Halometasone sequential therapy in the patients of plaque psoriasis. [Methods] 117 cases of plaque psoriasis col ected between 2011.01 and 2013.02 were randomly divided into treatment group and control group. The treatment group were treated with tacalcitol and Halometasone therapy, and required topical use Halometasone(1 time/day) in the morning ,tacalcitol use in the evening(1 time/day) before the first 2 weeks. Continuous two weeks treatment from Monday to Friday with tacalcitol(2 times/day), Saturday and Sunday with Halometasone(2 times/day), final y the transition to be used alone tacalcitol(2 times/day) in the next two weeks of continuous treatment. Control group of pa-tients given alone Halometasone(2 times/day) for 6 consecutive weeks. Observe the adverse reactions PASI scores during and after completion of treatment within the two groups. Al patients were fol owed for three months, observed recurrence. [Results] The PASI score between two groups of patients declined during treatment, especial y at the 4th and 6th week within the treatment group. Both groups had no serious adverse reactions. In treatment group, 54 patients had effective responses, the total effective rate was 90%, significantly better than the control group(41 cases,71.9%). In the fol ow-up of 3 months, the recur-rence rate was 11.1%in the treatment group, significantly lower than the control group(31.6%). The difference of total efficiency and the recurrence rate with-in the two groups was statistical y significant. [Conclusion] Tacalcitol combined Halometasone sequential therapy of plaque psoriasis has significant clinical effi-cacy and low recurrence rate.
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Objective To evaluate the effect of tacalcitol on the proliferation,adhesion,migration and c-kit mRNA expression of cultured human epidermal melanocytes.Methods Cultured epidermal melanocytes from the prepuce of adolescent males were treated with various concentrations of tacalcitol.Then,cell proliferation was evaluated by tetrazolium salt (XTT) assay after 24,48 and 72 hours of treatment,adhesive activity by using fibronectin-coated culture plates after 72 hours,migratory activity by Transwell assay using a microporous membrane after 24 hours,and the c-kit mRNA expression was semiquantitatively analyzed by reverse transcription PCR after 72 hours of treatment.Statistical analysis was done by repeated-measure analysis of variance and completely random design analysis of variance.Results As repeated-measure analysis of variance showed,tacalcitol of 10-10,10-9,10-8,10-7 and 10-6 mol/L significantly promoted the proliferation of melanocytes (F =9.47,P ＜ 0.01),with significant differences in the promoting effect among various durations of treatment with different concentrations of tacalcitol (F =14.44,P ＜ 0.01),and with significant interaction effect between drug concentration and treatment duration (F =2.47,P ＜ 0.01).The highest proliferation level was observed in melanocytes treated with tacalcitol of 10-s mol/Lfor 72 hours.There was a significant increase in the adhesion rate of human epidermal melanocytes to fibronectin after treatment with tacalcitol of 10-8-10-7 mol/L for 72 hours (both P ＜ 0.01),number of melanocytes migrating through micropore membranes per high-power field (× 200) after treatment with tacalcitol of 10-9-10-8 mol/L for 24 hours (both P ＜ 0.01),and in the c-kit mRNA expression in melanocytes treated with tacalcitol of 10-9-10-7mol/L for 72 hours (all P ＜ 0.01).Conclusion Tacalcitol can promote melanocytes to proliferate,migrate,express c-kit mRNA,and adhere to fibronectin.
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Perforating lichen nitidus is an unusual variant of lichen nitidus. It is clinically characterized by umbilicated papules and histopathologically characterized by transepidermal elimination of inflammatory debris from granulomatous infiltrates. Most cases of perforating lichen nitidus are treated with topical corticosteroids, but long-term use of topical corticosteroids could provoke several side effects. Herein, we report a case of perforating lichen nitidus treated effectively and safely with topical tacalcitol ointment. We performed a dermoscopic examination for the perforating lichen nitidus lesion and found the characteristic "frogspawn" dermoscopic feature.
Subject(s)
Adrenal Cortex Hormones , Dermoscopy , Dihydroxycholecalciferols , Lichen Nitidus , LichensABSTRACT
Objective To compare the efficacy and safety of excimer laser 308 nm phototherapy alone and the combination of excimer laser 308 nm and topical application of vitamine D3 alanogue tacalcitol in the treatment of vitiligo. Methods Seventy-eight patients with vitiligo were enrolled in the single-blind clinical trial, treated with excimer laser 308 nm. The lesions were devided into two groups: patients in the experimental group were instructed to use tacalcitol ointment and the control group were applied with placebo ointment. The lesions were evaluated once per month and photos taken for analyses of clinical effects. Results The results in different locations were compared, the effective rates of the experimental group in cephalofacial site, trunk and limbs were 93.51%, 84.16 % and 42.35 %, respectively. The effective rates of control group in opposite and adjacent sites were 90.9 %, 77.45 % and 34.15 %, respectively (P ＜ 0.05). The comparison of results in different types of lesions indicated that the effective rate of the experimental group in vitiligo vulgaris and segmental vitiligo were 73.81% and 84.00 %, respectively. The effective rate of control group in vulgaris and segmental vitiligo were 86.8 %, 77.45 % and 34.15 %, respectively (P ＜0.05 ). The comparison of results in radiation times and doses of phototherapy showed that the radiation time and dose on the time of initial pigment regeneration were (16. 15 ± 3.22)times and (4.40 ± 5.03)J/cm2 in the experimental group, while ( 18.56 ± 3.50) times and ( 6.60 ± 1.01 ) J/cm2 ( P ＜ 0.05 ) in the control group, the time and dose on the time of apparent effect were ( 20. 36 ± 1.50 ) times and ( 7.50 ± 3.54 ) J/cm2 in the experimental group, and (21.68 ± 2.40) times and( 8.80 ± 9.24)J/cm2 (P ＜ 0.05 ) in the control group. Conclusion Application of tacalcitol ointment in combination with twice-weekly 308 nm excimer laser light phototherapy is an effective alternative treatment for patients with generalized vitiligo.
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Objective To evaluate the efficacy of tacalcitol ointment combined with desonide cream in the treatment of plaque vulgaris psoriasis. Methods Sixty-six patients with plaque vulgaris psoriasis were assigned into combination treatment group and desonide sole treatment group by random digits table with 33 cases each. In combination treatment group, desonide cream was applied 1 time per day in the morning and tacalcitol ointment was applied 1 time per day at night. In desonide sole treatment group, desonide cream was applied twice one day. The therapy for two groups continued for 8 weeks. Results The total effective rate in combination treatment group was 78.79%( 26/33 ), and it was lower than that in desonide sole treatment group [84.85%(28/33)],but there was no significant difference between two groups (P>0.05). The recurrence rate was 25.00% (7/28) in desonide sole treatment group and 11.54% (3/26) in combination treatmentgroup,there was no statistical difference between two groups (P >0.05). There was no serious side effect during observation. Conclusions Tacalcitol ointment combined with desonide cream has no more effective for plaque vulgaris psoriasis than that of desonide cream alone. The combined use of these two drugs could reduce the dosage of steroid and side effect.
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Objective To study the efficacy and safety of tacalcitol combined with monochromatic excimer light (MEL) 308 nm vs MEL 308 nm monotherapy in treating vitiligo.Methods Thirty-eight pa- tients with vitiligo were enrolled in the single-blind clinical trial,using plabebo-treated lesions in the same patient as controls.Contralateral or nearby lesions were randomly selected to be treated by either tacalcitol or placebo.All lesions were treated weekly with MEL 308 nm,for a total of 12 sessions.Patients were ex- amined at monthly intervals.The mean number of sessions and the cumulative dosage for initial and excel- lent repigrnentation were calculated.Results Thirty-five patients were evaluated.The mean?SEM cumu- lative dose and number of MEL exposures for initial repigmentation,respectively,were 4.27?3.59 J/cm~2 and 4.89?3.16 on tacalcitol-treated site,5.36?4.12 J/cm~2 and 5.69?3.29 on placebo-treated site,re- spectively (both P＜0.05).For excellent repigrnentation,the cumulative dose and number of exposures were 7.72?5.64 J/cm~2 and 7.79?4.70 respectively on tacalcitol-treated site,and 8.18?4.87 J/cm~2 and 8.4?3.92 respectively on placebo-treated site (both P＞0.05).Treatment with tacalcitol resulted in a sig- nificantly higher percentage (71.4% vs 54.3%) of repigmentation than that with placebo.Conclusions Our results show that MEL 308 nm is safe and effective for the treatment of vitiligo.Additionally,concur- rent topical tacalcitol potentiates the efficacy of MEL 308 nm in the treatment of vitiligo;this combination achieves more rapid pigmentation with a lower total MEL dosage.