TOPICAL CALCIPOTRIENE IN COMBINATION WITH UVB PHOTOTHERAPY FOR PSORIASIS

A total of 20 patients with symmetric plaque-type psoriasis were recru ited for a controlled, investigator-blinded, right-left study. None of the patients had used any therapy other than emollients for 2 months prior to starting in the trial. All patients had a negative antinuclea r antibody. By history, all patients had previously improved upon expo sure to sunlight or ultraviolet light. Two symmetrical sites of equal severity were selected as target areas. Each patient was treated on on e side with mineral oil twice daily and on the opposite side with calc ipotriene 0.005% ointment twice daily. The investigator was blinded as to which site received which topical treatment. Both sides were treat ed with equal doses of ultraviolet B (UVB) three times weekly in gradu ated suberythemogenic doses. Ultraviolet B radiation was emitted by a group of 6-ft fluorescent bulbs (Light Sources FS72 T12 UVB HO) in a s tandard phototherapy unit.The above regimen was continued for a total of 12 weeks. The severity of psoriasis in the target sites was rated b y the examiner at baseline and at weekly intervals for the 12 weeks of study. Target sites were rated by severity of erythema, scaling, plaq ue elevation, and pruritus, with each of these parameters being assign ed a score on a four-point scale: 0, clear; 1, mild; 2, moderate; 3, s evere. The four scores were added together to arrive at a total severi ty score for each of the target sites. Statistical analysis was perfor med using the paired t test, P values less than 0.05 were considered s tatistically significant. Eleven of the 20 patients (55%) showed a gre ater decrease in the severity of their psoriasis with UVB plus calcipo triene compared with UVB plus mineral oil. The difference in severity scores between the two groups was statistically significant as early a s week 1 (P < 0.05). The difference between the UVB and calcipotriene group versus the UVB and mineral oil group peaked between weeks 3 and 6. The differences then decreased but remained statistically significa nt through to week 12 (Fig. 1). There were no instances of local cutan eous irritation, but mild photosensitivity occurred symmetrically on b oth sides in three patients.