EPIDERMAL-CELL DNA CONTENT AND INTERMEDIATE FILAMENTS KERATIN-10 AND VIMENTIN AFTER TREATMENT OF PSORIASIS WITH CALCIPOTRIOL CREAM ONCE-DAILY, TWICE-DAILY AND IN COMBINATION WITH CLOBETASONE 17-BUTYRATE CREAM OR BETAMETHASONE 17-VALERATE CREAM - A COMPARATIVE FLOW CYTOMETRIC STUDY

Calcipotriol and corticosteroids, two therapy modalities frequently pr escribed in the treatment of psoriasis, are often used in combination. The aim of the present study was to determine whether the cell biolog ical response pattern of concurrent use of calcipotriol and corticoste roids is different from calcipotriol monotherapy, Forty patients with chronic plaque psoriasis were divided at random in four parallel group s and treated for 8 weeks with: (1) calcipotriol cream (50 mu g/g once daily); (2) calcipotriol cream twice daily; (3) calcipotriol and clob etasone 17-butyrate (0.5 mg/g) creams; and (4) calcipotriol and betame thasone 17-valerate (1 mg/g) creams, Before and after treatment kerato tome biopsies were taken and single cell suspensions prepared for now cytometric analysis, Flow cytometric multiparameter quantification of markers for proliferation (TO-PRO-3), differentiation (antikeratin 10) and inflammation (antivimentin) was used to evaluate all four therapy modalities. A statistically significant decrease of the percentage of basal cells in S- and G(2)M-phase (proliferation) was obtained with a ll therapy modalities, except for calcipotriol monotherapy applied onc e daily. A significant reduction of the number of vimentin-positive ce lls (non-keratinocytes) was observed following combined treatment with calcipotriol acid clobetasone butyrate. In contrast, monotherapy with calcipotriol had virtually no effect on the number of vimentin-positi ve cells. It can be concluded that: (i) calcipotriol monotherapy, appl ied once daily was less antiproliferative compared with twice daily ap plications of calcipotriol or the combined treatment with corticostero ids and that (ii) the combination of calcipotriol and corticosteroids proved to have a marked effect on the percentage of non-keratinocytes, in contrast to the modest effect of calcipotriol.