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Anthralin-Corticosteroid Combination Therapy in the Treatment of Chronic Plaque Psoriasis

Anthralin-Corticosteroid Combination Therapy in the Treatment of Chronic Plaque Psoriasis Abstract † A prospective randomized trial of anthralin in Lassar's paste compared with anthralin in 0.0125% clobetasol propionate in the treatment of chronic plaque psoriasis was undertaken. The psoriatic skin of patients treated with the corticosteroid-anthralin combination cleared significantly more quickly than those treated with anthralin alone, with a mean time to clearance of 14.9 days compared with 18.5 days, and with lower concentrations of anthralin. No significant difference was found in the rate of relapse of the two treatment groups, with relapse occurring in over 80% of patients within one year. Anthralin in 0.0125% clobetasol propionate was found to be an effective agent in the treatment of chronic plaque psoriasis, and one that was cosmetically acceptable to patients and nursing staff. An important disadvantage, however, was the development of a staphylococcal folliculitis in four of the 35 patients in which it was used. Because of this, anthralin in Lassar's paste remains our standard inpatient therapy, although the ease of use and cosmetic acceptability of anthralin in clobetasol propionate make it a useful remedy for outpatient use. (Arch Dermatol 1988;124:548-550) References 1. Ingram JT: The approach to psoriasis Br Med J 1953;2:591-594. 2. Vella Briffa D, Greaves MW, Warin A, et al: Relapse rate and long-term management of plaque psoriasis after treatment with photochemotherapy and dithranol . Br Med J 1981;282:937-940.Crossref 3. Williams DI, Wilkinson DS, Overton J, et al: Betamethasone 17-valerate, a new topical corticosteroid . Lancet 1964;1:1177-1179.Crossref 4. Schmoll M, Henseler T, Christophers E: Evaluation of PUVA, topical corticosteroids and the combination of both in treatment of psoriasis . Br J Dermatol 1978;99:693-702.Crossref 5. Boxley JP, Dawber RPR, Summerly R: Generalised pustular psoriasis on withdrawal of clobetasol propionate ointment . Br Med J 1975;2:255-256.Crossref 6. Cornell RC, Stoughton RB: Correlation of the vasoconstriction assay and clinical activity in psoriasis . Arch Dermatol 1985;121:63-67.Crossref 7. Wilson L: The clinical assessment of topical corticosteroid activity . Br J Dermatol 1976;94( (suppl 12) ):33-42.Crossref 8. Sparkes CG, Wilson L: The clinical evaluation of a new topical corticosteroid, clobetasol propionate . Br J Dermatol 1974; 90:197-203.Crossref 9. Clement M, Hehir M, Phillips H, et al: The effects on epidermal DNA synthesis of a combination of topical steroid with either dithranol or tar as used for psoriasis . Br J Dermatol 1983;109:327-335.Crossref 10. Farber EM, Harris DR: Hospital treatment of psoriasis . Arch Dermatol 1970;101:381-396.Crossref 11. Seville RH: Relapse of psoriasis worsened by adding steroids to a dithranol regimen . Br J Dermatol 1976;95:643-646.Crossref 12. Munro DD, Pringle WM: Psoriasis: Its response to dithranol and clobetasol propionate: A comparative study , in Wilson L, Marks R (eds): Mechanisms of Topical Corticosteroid Activity . London, Churchill Livingstone Inc, 1976, pp 54-60. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Anthralin-Corticosteroid Combination Therapy in the Treatment of Chronic Plaque Psoriasis

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1988.01670040050021
Publisher site
See Article on Publisher Site

Abstract

Abstract † A prospective randomized trial of anthralin in Lassar's paste compared with anthralin in 0.0125% clobetasol propionate in the treatment of chronic plaque psoriasis was undertaken. The psoriatic skin of patients treated with the corticosteroid-anthralin combination cleared significantly more quickly than those treated with anthralin alone, with a mean time to clearance of 14.9 days compared with 18.5 days, and with lower concentrations of anthralin. No significant difference was found in the rate of relapse of the two treatment groups, with relapse occurring in over 80% of patients within one year. Anthralin in 0.0125% clobetasol propionate was found to be an effective agent in the treatment of chronic plaque psoriasis, and one that was cosmetically acceptable to patients and nursing staff. An important disadvantage, however, was the development of a staphylococcal folliculitis in four of the 35 patients in which it was used. Because of this, anthralin in Lassar's paste remains our standard inpatient therapy, although the ease of use and cosmetic acceptability of anthralin in clobetasol propionate make it a useful remedy for outpatient use. (Arch Dermatol 1988;124:548-550) References 1. Ingram JT: The approach to psoriasis Br Med J 1953;2:591-594. 2. Vella Briffa D, Greaves MW, Warin A, et al: Relapse rate and long-term management of plaque psoriasis after treatment with photochemotherapy and dithranol . Br Med J 1981;282:937-940.Crossref 3. Williams DI, Wilkinson DS, Overton J, et al: Betamethasone 17-valerate, a new topical corticosteroid . Lancet 1964;1:1177-1179.Crossref 4. Schmoll M, Henseler T, Christophers E: Evaluation of PUVA, topical corticosteroids and the combination of both in treatment of psoriasis . Br J Dermatol 1978;99:693-702.Crossref 5. Boxley JP, Dawber RPR, Summerly R: Generalised pustular psoriasis on withdrawal of clobetasol propionate ointment . Br Med J 1975;2:255-256.Crossref 6. Cornell RC, Stoughton RB: Correlation of the vasoconstriction assay and clinical activity in psoriasis . Arch Dermatol 1985;121:63-67.Crossref 7. Wilson L: The clinical assessment of topical corticosteroid activity . Br J Dermatol 1976;94( (suppl 12) ):33-42.Crossref 8. Sparkes CG, Wilson L: The clinical evaluation of a new topical corticosteroid, clobetasol propionate . Br J Dermatol 1974; 90:197-203.Crossref 9. Clement M, Hehir M, Phillips H, et al: The effects on epidermal DNA synthesis of a combination of topical steroid with either dithranol or tar as used for psoriasis . Br J Dermatol 1983;109:327-335.Crossref 10. Farber EM, Harris DR: Hospital treatment of psoriasis . Arch Dermatol 1970;101:381-396.Crossref 11. Seville RH: Relapse of psoriasis worsened by adding steroids to a dithranol regimen . Br J Dermatol 1976;95:643-646.Crossref 12. Munro DD, Pringle WM: Psoriasis: Its response to dithranol and clobetasol propionate: A comparative study , in Wilson L, Marks R (eds): Mechanisms of Topical Corticosteroid Activity . London, Churchill Livingstone Inc, 1976, pp 54-60.

Journal

Archives of DermatologyAmerican Medical Association

Published: Apr 1, 1988

References