A hydrocolloid occlusive dressing plus triamcinolone acetonide cream is superior to clobetasol cream in palmo-plantar pustulosis.
The purpose of this study was to compare the therapeutic efficacy of a hydrocolloid dressing (Actiderm) over a medium strength corticosteroid (triamcinolone acetonide (TAA) 0.1% cream) with that of a highly potent corticosteroid (clobetasol propionate 0.05% cream) in palmo-plantar pustulosis and localized pustular psoriasis. It was a randomized, open, prospective, right-left comparative trial in 19 patients. The Actiderm dressing and the TAA cream were applied every third day, whereas the clobetasol cream was applied twice daily for 4 weeks. Both treatments resulted in a significant improvement. On completion of treatment, complete clearance was found in 13 patients (63%) with Actiderm plus TAA, but in only 3 patients (21%) with clobetasol (p = 0.001). Four weeks after stopping therapy, the clinical parameters had returned to their pre-treatment level, except for erythema on the Actiderm plus TAA treated lesions (p less than 0.05). No clinically important adverse effects were reported or observed; in particular there was no sign of skin atrophy at the end of study. The results of this study demonstrate that Actiderm applied over a medium strength corticosteroid every third day is highly effective against palmoplantar pustulosis and localized pustular psoriasis. However, it is necessary to develop treatment regimens to maintain the improvement achieved.
Kragballe
K
K
Department of Dermatology, Marselisborg Hospital, University of Aarhus, Denmark.
Larsen
F G
FG
D000293:Adolescent; D000328:Adult; D000368:Aged; D047070:Bandages, Hydrocolloid; D002990:Clobetasol / Q000008:administration & dosage*; D003102:Colloids / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy; D006229:Hand Dermatoses / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
D003102:Colloids; D002990:Clobetasol; D014222:Triamcinolone Acetonide