Efficacy of calcipotriol ointment applied under hydrocolloid occlusion in psoriasis.
BACKGROUND
Hydrocolloid (HCD) dressings enhance the efficacy of topical corticosteroids.


OBJECTIVE
We wanted to evaluate the effect of calcipotriol ointment under an HCD dressing in the treatment of psoriatic plaques.


METHODS
In 9 psoriatic patients, we cleared one plaque using this approach and took biopsies at start, clearance and relapse. Clinical and immunohistochemical validation was assessed.


RESULTS
After an average treatment of 3.6 weeks, each lesion had cleared (apart from some residual erythema). The average remission period was 8 weeks. During this treatment, the number of cycling epidermal cells (Ki-67-positive nuclei) and the expression of keratin 14 and keratin 16 had decreased substantially. In biopsies taken from the skin immediately adjacent to the relapsing lesion, these markers remained reduced which indicated the prolonged effect of calcipotriol on epidermal differentiation.


CONCLUSIONS
It is speculated that combination therapy of calcipotriol with treatments with a different mode of action such as photo(chemo)therapy, corticosteroids and cyclosporine might be worthwhile.
Castelijns
F A
FA
Department of Dermatology, University Hospital Nijmegen, The Netherlands. f.castelijns@derma.azn.nl
Gerritsen
M J
MJ
van Erp
P E
PE
van de Kerkhof
P C
PC
D000328:Adult; D000368:Aged; D034961:Antigens, Nuclear; D017209:Apoptosis; D002117:Calcitriol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003102:Colloids / Q000009:adverse effects / Q000627:therapeutic use*; D017453:Dermatitis, Irritant / Q000209:etiology; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D053547:Keratin-14; D007633:Keratins / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000032:analysis; D009779:Occlusive Dressings; D009824:Ointments; D010352:Patient Dropouts; D011565:Psoriasis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D012867:Skin / Q000737:chemistry / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome
D034961:Antigens, Nuclear; D003102:Colloids; D003879:Dermatologic Agents; C507540:KRT14 protein, human; D053547:Keratin-14; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D009824:Ointments; C055085:calcipotriene; D007633:Keratins; D066246:ErbB Receptors; D002117:Calcitriol