ABSTRACT
OBJECTIVE: Evaluate and compare the efficacy, safety, and tolerability of coal tar (10% LCD, liquor carbonis detergens), with betamethasone valerate in the therapy of large plaque-type psoriasis. MATERIAL AND METHOD: Patients with stable, mild to moderate plaque psoriasis at the Department of Medicine, Lerdsin General Hospital, Bangkok, Thailand were randomized for treatment with either coal tar (10% LCD) cream or betamethasone valerate cream (0.1%). All patients entered a 2 week wash-out period followed by the creams being applied twice daily until completion at 6 weeks. The patient severity of psoriasis was assessed using the modified Psoriasis Area and Severity Index (PASI) score at baseline and after 2, 4, and 6 weeks of treatment. RESULT: At the end of the trial, the mean reduction of the PASI score from baseline was 38.39% with the coal tar group and 69.36% with the betamethasone valerate group. The mean percentage of the PASI score reduction was statistically significant in both groups but the betamethasone valerate group was significantly superior to the coal tar group. Both drugs' adverse effects were limited to mild irritation localized to the skin without systemic side effects. The Betamethasone valerate cream was safe, effective, and well-tolerated while the coal tar cream was described as messy, malodorous, and with a tendency to staining clothes. CONCLUSION: The investigator's overall assessment of the treatment response at completion of the trial demonstrated that the betamethasone valerate group achieved significantly greater clearance and marked improvement compared with the coal tar group.
Subject(s)
Adult , Aged , Anti-Inflammatory Agents/adverse effects , Betamethasone Valerate/adverse effects , Chronic Disease/drug therapy , Coal Tar/adverse effects , Disease Progression , Female , Health Status Indicators , Humans , Keratolytic Agents/adverse effects , Male , Middle Aged , Psoriasis/drug therapy , Thailand , Treatment OutcomeABSTRACT
Adolescent and post adolescent females presented to Dermatology Out patients with white comedones and inflamed papules, situated mainly on cheeks and forehead. Most of these patients related the onset of these lesions after continuous use of a beauty cream to improve complexion. Twenty four patients presenting to the Outpatients Department of Dermatology at Abbassi Shaheed Hospital and Burhani Community Hospital, were collected. Subjects were questioned about their acneiform eruption. Each patient was examined and beauty products and 17 betamethasone valerate cream were shown to them for correct identification. All patients related the lesions after continuous application of the beauty cream obtained after mixing 5gm tube of betamethasone valerate cream with one tube each of two famous beauty products. The average daily application lasted for about three months. The predominant lesions were white comedones and inflamed papules [100%]; macular erythema and telangiectasia were seen in [16%.] The cheeks and forehead were universally involved in all patients and the chin was involved in four [16%]. The majority belonged to middle and low-income families. Conclusions: Since time immemorial, females have used beauty products to improve their complexion. The recent amateur addition of 17- betamethasone valerate to commercial beauty creams has led to more acneiform eruptions