DITHRANOL EMBEDDED IN CRYSTALLINE MONOGLYCERIDES COMBINED WITH PHOTOTHERAPY (UVB) - A NEW APPROACH IN THE TREATMENT OF PSORIASIS

Treatment of psoriasis with dithranol as monotherapy or dithranol in c ombination with UVB phototherapy is an effective and safe approach for the management of psoriasis. Recently a new formulation of dithranol embedded in crystalline monoglycerides (Micanol) has become available. It was shown that this formulation combines adequate efficacy with lo w irritation and staining properties. The aim of the present study was to compare and contrast three treatment schedules with respect to cli nical efficacy and tolerability: Micanol monotherapy, Micanol in combi nation with UVB phototherapy and placebo combined with UVB phototherap y. The study design was a partly open, partly double-blind, randomized , left-right comparison. In total 36 patients were included and 24 bod y halves were available for each of the three treatments. The combinat ion of Micanol with UVB resulted in clearance of lesions in 54% of the patients (body halves). Combination therapies with Micanol and either of the two other therapies were highly effective. However, with the n umber of patients investigated, a statistically significant difference between the three therapeutic approaches with respect to efficacy cou ld not be shown. The three treatments resulted in a grosso mode compar able clinical improvement. Severe irritation was observed in 8% and st aining of the skin in 29% of the patients treated with the combination therapy Micanol/UVB, which is far less compared to the irritation and staining by the conventional short contact approaches. The efficacy a nd tolerability of Micanol make this active substance an important too l in the management of psoriasis.