Ceh. Grattan et al., A NEW AQUEOUS DITHRANOL GEL FOR PSORIASIS - COMPARISON WITH PLACEBO AND CALCIPOTRIOL OINTMENT, Journal of dermatological treatment, 8(1), 1997, pp. 11-15
A new aqueous dithranol gel has been developed to reduce irritation an
d staining by minimizing unwanted dithranol residue on the skin surfac
e. Left-right paired comparisons were conducted vs placebo (phase I) i
n 12 inpatients and vs calcipotriol ointment (phase II) in 25 inpatien
ts with symmetrical chronic plaque psoriasis to assess its efficacy an
d acceptability. In phase I, dithranol gel was significantly better th
an the placebo after 4 weeks treatment for each severity parameter, er
ythema, scale and palpability (P less than or equal to 0.022). Combine
d severity scores (maximum 9) fell from 6.3 to 1.1 with dithranol and
to 4.1 with placebo. In phase II, calcipotriol produced significantly
greater improvement after 3 weeks than dithranol gel, but there was no
difference after 4 weeks by which time severity scores fell from 6.3
to 2.2 with dithranol and to 1.8 with calcipotriol. There was a greate
r reduction in psoriasis area (P = 0.04) with calcipotriol but no over
all difference in the patients' assessment of effectiveness for either
treatment after 4 weeks use. At 4 and 12 weeks follow-up there was no
objective difference in severity, although more patients thought that
the caldpotriol-treated sites showed greater deterioration. Calcipotr
iol caused less irritation and staining than dithranol gel (P < 0.001)
. Dithranol in an aqueous gel formulation was effective for inpatient
treatment of chronic psoriasis and acceptable for patients, but showed
a higher incidence of irritation and staining than calcipotriol ointm
ent.