Comparative Study of Calcipotriol and Desoxymethasone Ointments in the Treatment of Psoriasis Vulgaris: The Clinical Effect and Immunohistochemical Change

Kim, Jo Yong; You, Young Ho; Kim, Tae Yoon; Kim, Chung Won

Abstract

BACKGROUND: Calcipotrol, topical vitamin D analogue, has been demonstrated to have an effect for the treatment of psoriasis with good tolerability. It is required to have comparative studies with the other topical agents which are widely used for the treatment of psoriasis.
OBJECTIVE
Our purpose is to compare calcipotriol with desoxymethasone ointemtn in their therapeutic efficacy and ability to affect dermal inflammatory cellular events.
METHODS
This study was a randomized, double blind, right/left comparison over 8weeks in 10 patients. The ointments were applied twice daily to the lesions of psoriasis. Clinical efficacy, as measured by the Psoriasis Area and Severity Index(PASI) was assessed at 2, 4, 6 and 8weeks after starting treatments. The changes in the numbers of dermal immunocytes were assessed on frozen and paraffin-embedded sections by using immunohistochemical stain methods before and after the treatemtns.
RESULTS
Reduction of PASI was statistically significant at all time points for both of the treatments (P<0.01) but there was no significant defference between the two treatment modalities. At the completion of 8 weeks of treatments, the mean PASI reduction was 65 percents and 67 percents for calcipotriol and desoxymethasone ointments, respectively. On immunohistochemical staining, the numbers of LCA and HLA-DR positive cells were decreased significantly(P<0.05), and IL-2R and CD4 positive cells were not significaltly reduced in each group after the treatment.
CONCLUSION
Calcipotriol ointment was as effective as desoxymethasone ointment, judged by the PASI and the dermal inflammatory cellular events on immunohistochemical staining.