Treatment of psoriasis with a new combination of calcipotriol and betamethasone dipropionate: a flow cytometric study.
BACKGROUND
Calcipotriol and corticosteroids are established topical antipsoriatics. Previous studies have shown that combined therapy with calcipotriol and betamethasone dipropionate was more effective than monotherapy. In the present study, a recently developed combination product of calcipotriol and betamethasone dipropionate was compared with both monotherapies and the vehicle.


METHODS
Twenty-five psoriatic patients were treated twice daily with the combination product, monotherapy or vehicle during 4 weeks. Skin biopsies, taken before and after treatment, were analysed using a multi-parameter flow cytometric method. Parameters of inflammation (vimentin-positive cells), normal differentiation (keratin-10-positive cells) and proliferation (cells in SG(2)M-phase) were assessed.


RESULTS
Flow cytometric analysis showed that the combination product turned out to be more effective in reducing inflammation compared with the other treatments. Restoration of normal differentiation was more advanced in patients treated with the combination product or betamethasone dipropionate compared to the vehicle. The highest number of normally differentiated cells was seen after use of the combination product. All treatments, except for the vehicle, decreased hyperproliferation. CONCLUSIONS This study shows that the combination product is a valuable new approach to the treatment of psoriasis.
van Rossum
M M
MM
Department of Dermatology, University Medical Centre St. Radboud, Nijmegen, The Netherlands. m.vanrossum@derma.azn.nl
van Erp
P E
PE
van de Kerkhof
P C
PC
D000328:Adult; D000368:Aged; D001623:Betamethasone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D002453:Cell Cycle / Q000187:drug effects; D002455:Cell Division / Q000187:drug effects; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D053550:Keratin-10; D007633:Keratins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000378:metabolism; D012867:Skin / Q000737:chemistry / Q000187:drug effects / Q000473:pathology; D014746:Vimentin / Q000032:analysis
D003879:Dermatologic Agents; D004338:Drug Combinations; C507493:KRT10 protein, human; D014746:Vimentin; C055085:calcipotriene; D053550:Keratin-10; D007633:Keratins; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone; D002117:Calcitriol