title: Proactive treatment with calcipotriol reduces recurrence of plaque psoriasis.
abstract: Topical calcipotriol is a widely used treatment for plaque-type psoriasis worldwide, and has been shown to improve psoriatic plaques as well as very potent corticosteroids. However, there remains the practical question of whether calcipotriol application should continue on healed pigmentation/depigmentation associated with psoriatic plaques. Therefore, we conducted a pilot clinical study to answer this question. Plaque-type psoriatic patients not receiving systemic treatment were enrolled and treated with calcipotriol for 8 weeks (stage I) to achieve maximum effect. The patients were then divided into two groups: group A continued to apply calcipotriol to the entirety of the previous lesion (including pigmentation/depigmentation) regardless of whether skin was healed or not, while group B applied calcipotriol to the remaining lesion only. Patients were followed for 12 weeks (stage II) and dates of plaque recurrence were recorded. A total of 29 patients (13 men, 16 women) were enrolled. During stage I, reductions in scores for redness, induration and scale occurred in 40%, 47% and 55% of patients, respectively. After stage II was completed, group A (n = 19) showed a significantly better Kaplan-Meier curve of non-recurrence than group B (n = 8, P < 0.01). The mean non-recurrence duration was 76.8 ± 11.8 in group A and 35.0 ± 12.0 in group B. Our study showed that applying topical calcipotriol on seemingly healed psoriatic plaque lesions suppresses recurrence better than applying it only on remaining plaques. This finding may be important for instructing psoriatic patients on topical calcipotriol treatment.
authors.affiliation: Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Monji
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Shibayama
authors.affiliation: Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Tatematsu
authors.affiliation: Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Juichiro
authors.initials: J
authors.lastname: Nakayama
authors.affiliation: Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Imafuku
mesh_terms: D000287:Administration, Topical; D000368:Aged; D002117:Calcitriol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011565:Psoriasis / Q000188:drug therapy*; D011897:Random Allocation; D055502:Secondary Prevention / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; C055085:calcipotriene; D002117:Calcitriol
keywords: calcipotriol; proactive treatment; psoriasis; recurrence; topical therapy