[The effect of initial external glucocorticoid administration on cignolin treatment of psoriasis].
In a randomized open study we compared the effect of conventional dithranol therapy (CSV-therapy, 7 patients) with a combination regimen, in which patients were pretreated with a 0.064% betametason dipropionate ointment (Diprosis) for 1 week before the onset of dithranol therapy (B + CSV-therapy). Clinical evaluation was performed by grading 4 representative lesions per patient for erythema, plaque thickness and scaling every week (EPS-score). After one week of therapy glucocorticoid was superior to dithranol (reduction of EPS-scores 68% vs. 35%). Thereafter the benefit of CSV-therapy surpassed that of B + CSV-therapy. 33 days after onset of therapy there was a 95% reduction of skin lesions in the CSV-group compared to a 75% reduction in the B + CSV-group. In terms of a 95% reduction the CSV-group required 32.9 +/- 5.5 days versus 45.1 +/- 19.7 days of the B + CSV-group. During the 6 months follow-up relapses occurred in 3 of 7 patients of the CSV-group 15.32 and 34 days after discontinuation of therapy and in 2 of 7 patients of the B + CSV-group 64 and 82 days after discontinuation of therapy. The present findings reveal that a pretreatment of psoriasis with topical glucocorticoids reduces the response to dithranol and the duration of remission.
Universitäts-Hautklinik Köln.
G
G
Mahrle
H J
HJ
Schulze
D000287:Administration, Topical; D000875:Anthralin / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001623:Betamethasone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone; D000875:Anthralin
Der Effekt einer initialen äusserlichen Glukokortikoid-anwendung auf die Cignolinbehandlung der Psoriasis.