One-alpha-hydroxy vitamin-D3 in psoriasis vulgaris patients with special reference to lacrimal glands tear secretion

None of the drugs currently in use in treatment of psoriasis is ideal and without side effects. In this study 30 patients of psoriasis vulgaris were treated with the oral vitamin D3 analogue one alpha-OH- D3 [one alpha tablet-Leo Pharmaceutica] in a dose of 1.0 ug per day for successive 20 weeks. Response of the drug was evaluated by applying the new psoriasis area and severity index [PASI] technique before, during and after commencement of therapy. Also, lacrimal glands tear secretion was evaluated using Schirmer's one test before and after therapy and compared with normal 30 age and sex matched subjects [control group]. Psoriatic skin lesions showed satisfactory improvement in 60% of the studied patients with a percent reduction in PASI of more than 50. Psoriatic patients showed significant low tear secretion of their eyes compared with the normal control group, which aroused the possibility of association of dry eyes syndrome with psoriasis. Nonsignificant reduction in Schirmer's one test values was observed in patients after the course of therapy. No significant changes were occurred in levels of serum calcium, phosphorus or parathormone due to one alpha-OH-D3 drug use in the studied group of patients. Very little and negligible side effects were reported during the drug use in three patients only out of 30. It was concluded that one alpha-OH-D3 is an effective and side effect free drug modality in the treatment of psoriasis vulgaris. Combined therapy of one alpha-OH-D3 oral tablets with other systemic drugs currently used in treatment of psoriasis requires further evaluation, especially those drugs affecting the immune system of the patients

Cyproterone acetate in acne vulgaris in females: clinico therapeutic and biochemical studies

A generally accepted, single treatment modality for acne vulgaris is still a puzzle. An open study is carried out on 50 female patients to assess the clinical efficacy of an antiandrogen on acne lesions as well as on comedonal structures. Each female patient received one pill every day starting from the 5th day of the menstrual period and for successive 21 days followed by 7 days pills-free period. Pills contained 2 mg cyproterone acetate combined with 50 Ug ethinyl-oestradiol per pill, this cyclic therapy is repeated for 4 months. Before and after treatment, all patients were subjected to clinical evaluation by counting the number of lesions and by general patient and observer assessment. 20 of the cases were selected with plenty of comedones. Comedonal contents were collected to estimate the level of triglycerides, free fatty acids and cholesterol in their material. It was found that the antiandrogen [cyproterone acetate] was greatly effective in the inflammatory types of acne vulgaris lesions [papules, pustules, cysts and nodules] in all cases. Comedones also showed a good reduction in their number, however, cysts and nodules showed marked reduction in their inflammatory nature, without affection of their number. The levels of triglycerides, free fatty acids and cholesterol before treatment were 0.204 +/- 0.1, 0.257 +/- 0.1 and 0.456 +/- 0.14 mmol/gm comedones respectively which can be considered as their values in acne patients. These values were significantly reduced after treatment only in triglycerides and free fatty acids while cholesterol showed a nonsignificant reduction. Side-effects of the drug used were minimal and negligible if compared to its satisfactory clinical effects. We can advice the use of the antiandrogen "Cyproterone acetate" combined with ethinyloestradiol especiall;y in cases with inflammatory lesions of acne in females, especially married ones wishing to use a contraceptive measure