Calcitriol vs. dithranol in combination with narrow-band ultraviolet B (311 nm) in psoriasis.
BACKGROUND
Narrow-band ultraviolet (UV) B (311 nm) phototherapy is an effective treatment for psoriasis. In order to reduce cumulative UV doses and to enhance clearance of psoriasis plaques, combination therapies with topical agents such as dithranol and calcipotriol have been established.


OBJECTIVE
To compare the clinical efficacy, in a half-side manner, of UVB (311 nm) in combination with either calcitriol or dithranol.


METHODS
Ten patients with symmetrical stable plaque psoriasis were treated with narrow-band UVB (311 nm) five times a week. In addition, topical calcitriol was applied twice daily to one arm, whereas the other arm and the rest of the body were treated once daily with dithranol. The follow-up period was at least 4 weeks. Efficacy was assessed separately for both arms prior to treatment and once weekly thereafter by a modified Psoriasis Area and Severity Index (PASI) score. The cumulative irradiation dose and the number of treatment sessions required for clearance of psoriasis lesions were determined for each patient. Additionally, all patients completed a quality of life questionnaire.


RESULTS
Both treatment modalities notably reduced the PASI score. A clinical comparison of UVB (311 nm) in combination with either calcitriol or dithranol revealed no significant therapeutic differences between the regimens.


CONCLUSIONS
Combination of narrow-band UVB (311 nm) therapy with calcitriol is equally effective as the combination with dithranol for the treatment of psoriasis. However, patients preferred calcitriol rather than dithranol when both quality of life and treatment acceptability were assessed.
Hofmann
U B
UB
Department of Dermatology, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany. uta.hofmann@mail.uni-wuerzburg.de
Eggert
A A O
AA
Bröcker
E-B
EB
Goebeler
M
M
D000287:Administration, Topical; D000328:Adult; D000875:Anthralin / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002117:Calcitriol / Q000627:therapeutic use*; D002120:Calcium Channel Agonists / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011565:Psoriasis / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014467:Ultraviolet Therapy
D000893:Anti-Inflammatory Agents; D002120:Calcium Channel Agonists; D002117:Calcitriol; D000875:Anthralin