Calcipotriol ointment versus cream in psoriasis vulgaris.

Abstract

Psoriasis is a multifactorial, chronically relapsing, inflammatory skin disease occurring in 1-3% of the world's population. Vitamin D3 analogs have effects on proliferation and differentiation, as well as on the infiltration and activation of neutrophils and immunocytes in psoriatic skin lesions. This study aims to assess the efficacy and safety of topical calcipotriol and to compare ointment and cream formulations in the treatment of psoriasis vulgaris. A total of 41 patients with mild to moderate psoriasis vulgaris (18 men and 23 women aged between 5 and 63 years) were enrolled in the study. Each patient was instructed to apply the treatment twice daily over the psoriatic lesions. Routine blood tests and serum calcium were performed prior to and at the end of treatment. Treatment assessment was carried out on weeks 2, 4 and 6 and was based on the Psoriasis Area and Severity Index (PASI) score. Of the 41 patients included in our study, only 29 completed the treatment course. Their PASI before treatment ranged from 1.2 to 43 (mean: 12.1). Both groups, calcipotriol 50 microg/g ointment (11 patients) and calcipotriol 50 microg/g cream (18 patients) showed time-dependent improvement and after 6 weeks there was excellent improvement with a marked reduction in the total mean PASI from 12.1 to 1.02. There was a significant reduction of PASI in the ointment group in comparison with the cream group (mean PASI from 12.7 to 0.8 and 11.1 to 1.15, respectively). No significant adverse effects were observed in either group, except for mild irritation in a few patients in the calcipotriol cream group. In conclusion, calcipotriol was effective, safe and well tolerated in the treatment of psoriasis vulgaris and better results were observed with the ointment formulation. Longer treatment courses could be advised.