EVALUATION OF THE EFFECTIVENESS OF TOPICAL TREATMENT COMBINATION OF BETAMETHASONE DIPROPIONATE 0.05%/CALCIPOTRIOL MONOHYDRATE 0.005% GEL AND CLOBETASOLE PROPIONATE 0.05% OINTMENT IN PATIENTS WITH PSORIATIC ONYCHODYSTROPHY


Cite item

Full Text

Abstract

Psoriatic onychodystrophy is a comorbidity that often occurs in patients with psoriasis, affecting their quality of life. Although success has recently been achieved in the treatment of the cutaneous form of psoriasis, there are few publications about nail therapy with proven effectiveness. The development of effective and safe therapies remains relevant for nail psoriasis. Objective. to evaluate the effectiveness and tolerability of the fixed combination of betamethasone dipropionate 0.05%/calcipotriol monohydrate 0.005% gel and clobetasole propionate 0.05% ointment in patients with psoriatic onychodystrophy. Material and methods. the study included 50 patients with psoriasis vulgaris, mild to moderate severity with lesions of the nail plates. Patients were divided into two groups and used betamethasone dipropionate 0.05%/calcipotriol monohydrate 0.005% gel (group A) and clobetasole propionate 0.05% ointment with occlusion (group B) for 24 weeks with hardware treatment of nail plates at 0, 8, 16 weeks. They did not receive any other local or systemic treatment. The severity of nail psoriasis was assessed by the NAPSI index at week 0, 8, 16, and 24, and by the IGA after treatment. results. 43 patients completed the study. At the beginning of the study, the average NAPSI was 32.8 ± 10.3 in group A and 33.1 ± 9.8 in group B. At week 24 the average NAPSI score decreased to 12.8 ± 7.2 in group A and 11.8 ± 68 in group B. IGA for evaluation treatment score was 3 ± 0.74 in group A and 3.1 ± 0.79 in group B. Conclusions. Combined treatments in the form of hardware processing nail plates with betamethasone dipropionate 0.05%/calcipotriol monohydrate 0.005% gel and clobetasol propionate 0.05% ointment are effective and can be used in patients with moderate and severe nail psoriasis, which is confirmed by the results in clinical improvement of 60.8% and 64.5%, respectively, based on a decrease in NAPSI at 24 weeks and an assessment of the therapeutic response after treatment using the IGA.

About the authors

Ivan S. Maximov

Department of Dermatology and Venereology of I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: maximov.is@mail.ru
assistant of the Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation Moscow, 119991, Russian Federation

N. G Kochergin

Department of Dermatology and Venereology of I.M. Sechenov First Moscow State Medical University (Sechenov University)

Moscow, 119991, Russian Federation

V. S Novoselov

Department of Dermatology and Venereology of I.M. Sechenov First Moscow State Medical University (Sechenov University)

Moscow, 119991, Russian Federation

D. I Ushakova

Department of Dermatology and Venereology of I.M. Sechenov First Moscow State Medical University (Sechenov University)

Moscow, 119991, Russian Federation

References

  1. Parisi R., Symmons D.P., Griffiths C.E., Ashcroft D.M. Identification and Management of Psoriasis and Associated ComorbidiTy (IMPACT) project team. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J. Inves.t Dermatol. 2013; 133(2): 377-85.
  2. Reich K. Approach to managing patients with nail psoriasis. J. Eur. Acad. Dermatol. Venereol. 2009; 23(Suppl. 1): 15-21.
  3. Pasch M.C. Nail psoriasis: a review of treatment options. Drugs. 2016; 76(6): 675-705.
  4. de Jong E.M., Seegers B.A., Gulinck M.K., Boezeman J.B., van de Kerkhof P.C. Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients. Dermatology. 1996; 193(4): 300-3.
  5. Lawry M. Biological therapy and nail psoriasis. Dermatol. Ther. 2007; 20(1): 60-7.
  6. Jiaravuthisan M.M., Sasseville D., Vender R.B., Murphy F., Muhn C.Y. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J. Am. Acad. Dermatol. 2007; 57(1): 1-27.
  7. Salomon J., Szepietowski J.C., Proniewicz A. Psoriatic nails: a prospective clinical study. J. Cutan. Med. Surg. 2003; 7(4): 317-21.
  8. Maejima H., Taniguchi T., Watarai A., Katsuoka K. Evaluation of nail disease in psoriatic arthritis by using a modified nail psoriasis severity score index. Int. J. Dermatol. 2010; 49(8): 901-6.
  9. Langenbruch A., Radtke M.A., Krensel M., Jacobi A., Reich K., Augustin M. Nail involvement as a predictor of concomitant psoriatic arthritis in patients with psoriasis. Br. J. Dermatol. 2014; 171(5): 1123-8.
  10. Williamson L., Dalbeth N., Dockerty J.L., Gee B.C., Weatherall R., Wordsworth B.P. Extended report: nail disease in psoriatic arthritis - clinically important, potentially treatable and often overlooked. Rheumatology (Oxford). 2004; 43(6): 790-4.
  11. Augustin M., Reich K., Blome C., Schafer I., Laass A., Radtke M.A. Nail psoriasis in Germany: epidemiology and burden of disease. Br. J. Dermatol. 2010; 163(3): 580-5.
  12. Klaassen K.M., Dulak M.G., van de Kerkhof P.C., Pasch M.C. The prevalence of onychomycosis in psoriatic patients: systematic review. J. Eur. Acad. Dermatol. Venereol. 2014; 28(5): 533-74.
  13. Gupta A.K., Lynde C.W., Jain H.C., Sibbald R.G., Elewski B.E., Daniel C.R., et al. A higher prevalence of onychomycosis in psoriatics compared with non-psoriatics: a multicentre study. Br. J. Dermatol. 1997; 136(5): 786-9.
  14. Blauvelt A., Armstrong A.W., Krueger G.G. Essential truths for the care and management of moderate-to-severe psoriasis. J. Drugs Dermatol. 2015; 14(8): 805-12.
  15. Crowley J.J., Weinberg, J.M., Wu J.J., Robertson A.D., Van Voorhees A.S.; National Psoriasis Foundation. Treatment of nail psoriasis: best practice recommendations from the Medical Board of the National Psoriasis Foundation. JAMA Dermatol. 2015; 151(1): 87-94.
  16. Saki N., Hosseinpoor S., Heiran A., Mohammadi A., Zeraatpishe M. Comparing the efficacy of triamcinolone acetonide iontophoresis versus topical calcipotriol/betamethasone dipropionate in treating nail psoriasis: A bilateral controlled clinical trial. Dermatol. Res. Pract. 2018; 2018: 2637691. doi: 10.1155/2018/2637691.
  17. Tan E.S., Oon H.H. Effective treatment of severe nail psoriasis using topical calcipotriol with betamethasone dipropionate gel. Indian J. Dermatol. Venereol. Leprol. 2016; 82(3): 345-7.
  18. Arango-Duque L.C., Roncero-Riesco M., Usero Barcena T., Palacios Alvarez I., Fernandez Lopez E. Treatment of nail psoriasis with Pulse Dye Laser plus calcipotriol betametasona gel vs. Nd:YAG plus calcipotriol betamethasone gel: An intrapatient left-to-right controlled study. Actas Dermosifiliogr. 2017; 108(2): 140-4.
  19. Rigopoulos D., Gregoriou S., Daniel Iii C.R., Belyayeva H., Larios G., Verra P., et al. Treatment of nail psoriasis with a two-compound formulation of calcipotriol plus betamethasone dipropionate ointment. Dermatology. 2009; 218(4): 338-41.
  20. De Simone C., Maiorino A., Tassone F., D’Agostino M., Caldarola G. Tacrolimus 0.1% ointment in nail psoriasis: a randomized controlled open-label study. J. Eur. Acad. Dermatol. Venereol. 2013; 27(8): 1003-6.
  21. Boontaveeyuwat E., Silpa-Archa N., Danchaivijitr N., Wongpraparut C. A randomized comparison of efficacy and safety of intralesional triamcinolone injection and clobetasol propionate ointment for psoriatic nails. J. Dermatol. Treat. 2019; 30(2): 117-22.
  22. Brown M.B., Khengar R.H., Turner R.B., Forbes B., Traynor M.J., Evans C.R., et al. Overcoming the nail barrier: A systematic investigation of ungual chemical penetration enhancement. Int. J. Pharm. 2009; 370(1-2): 61-7.

Copyright (c) 2019 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies