Calcipotriol ointment vs. betamethasone 17-valerate ointment in the treatment of lichen amyloidosis

Sixteen Asian patients (6 men and 10 women), in the age range 41-74 years, presenting clinically with symmetrically distributed lichen amyloidosis (LA ) on the extremities, were enrolled in this double-blind, right-left compar ison pilot study to evaluate the efficacy of calcipotriol ointment (50 mu g /g) vs. betamethasone 17-valerate ointment (0.1%). This trial was conducted in a tertiary skin referral center in Singapore an d consecutive patients with LA were recruited over a 3-month period. Exclud ed were patients who were pregnant or lactating, patients with known contac t allergy to either calcipotriol or topical steroid, patients with hypercal cemia, and those with significant hepatic or renal disease. After a washout period of 2 weeks, the ointments were applied separately to either the right or left extremities twice daily for a period of 12 weeks. Assessments were made at weeks 0, 4, 8, and 12 by both the physician and t he patient. Treatment responses were assessed as follows: roughness (visual analog scale of 1-10, 1 being the least rough and 10 being the most rough) , hyperpigmentation (visual analog scale of 1-10, 1 being the least hyperpi gmented and 10 being the most hyperpigmented), and any adverse events. An a dditional parameter assessed by the patient was pruritus (visual analog sca le of 1-10, 1 being the least pruritic and 10 being the most pruritic). Cli nical photographs were taken during each review. For analyses of the responses, the mean roughness score is defined as the a verage sum of the roughness score of all patients for each treated side. Li kewise the mean hyperpigmentation score and the mean pruritus score are def ined as the average sum of hyperpigmentation and the average sum of pruritu s, respectively. Any score differences observed between week 0 and week 12 within the two treatment groups were analyzed by Wilcoxon signed ranked tes t for statistical significance; differences in scores between the two treat ment groups were analyzed by Mann-Whitney U-test.