Comparison of the effects of pulsed dye laser, pulsed dye laser + salicylic acid, and clobetasole propionate + salicylic acid on psoriatic plaques.
BACKGROUND
Studies show that pulsed dye laser (PDL) has some clinical benefits on psoriasis with a low clearance rate. In addition, it has been suggested that applying keratolytics before treatment might be helpful in PDL therapy. Topical corticosteroids remain the most commonly prescribed agents for psoriasis.


OBJECTIVE
This study was designed to compare the efficacy of the PDL treatment with that of PDL treatment after salicylic acid on psoriatic plaques. The other goal of this study was to compare the efficacy of the PDL treatment with that of clobetasol propionate treatment.


METHODS
Twenty-two patients with chronic, stable psoriatic plaques that involved less than 20% of their body were included in the study. Three similar-appearing psoriasis plaques in these patients were selected. Whereas the first plaque received only PDL, the second plaque received PDL after salicylic acid, and the third plaque received clobetasol propionate ointment and salicylic acid. Evaluation of the study plaques was carried out by the modified Psoriasis Area and Severity Index (mPASI) score and by measuring the area of the plaques.


RESULTS
Of the 21 patients, 19 completed the study. Although the decrease in mPASI scores was determined to be maximum for clobetasol propionate + salicylic acid-treated plaques and minimum for only PDL-treated plaques, the decrease was statistically significant in all groups when compared with baseline (p < .003). At the 3- and 6-week evaluations, there was a statistically significant difference between clobetasol propionate + salicylic acid-treated plaques and the two PDL-treated plaques (p < .003); however, the difference observed at the 9-, 12-, and 15-week evaluations was statistically significant only between clobetasol propionate + salicylic acid-treated plaques and PDL-treated plaques (p < .003). When the baseline and 15-week evaluations were compared, there was no statistically significant increase in the mean lesion areas of clobetasol propionate + salicylic acid-treated psoriatic plaques (p > .003), but there was a statistically significant increase in the mean lesion areas of two PDL-treated psoriatic plaques (p < .003).


CONCLUSIONS
The results of this study showed that the effect of PDL could be increased when salicylic acid was added to treatment, although there was no statistically significant difference between both treatment protocols. However, clobetasol propionate + salicylic acid treatment is more effective than both PDL and PDL + salicylic acid treatment.
Ilknur
Turna
T
Department of Dermatology, Faculty of Medicine, Dokuz Eylül University, 35340 Izmir, Turkey. turna.ilknur@deu.edu.tr
Akarsu
Sevgi
S
Aktan
Sebnem
S
Ozkan
Sebnem
S
D000328:Adult; D000368:Aged; D002990:Clobetasol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage*; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000473:pathology / Q000628:therapy*; D020156:Salicylic Acid / Q000008:administration & dosage*; D016896:Treatment Outcome
D005938:Glucocorticoids; D007641:Keratolytic Agents; D002990:Clobetasol; D020156:Salicylic Acid