Mehta Bijal H, Amladi Sangeeta T
Minal Specialised Clinic Dermatology, Sharjah, United Arab Emirates.
Indian J Dermatol. 2011 Jan;56(1):40-3. doi: 10.4103/0019-5154.77550.
Palmoplantar psoriasis is a frequently encountered variant of psoriasis. It is difficult to treat and even more difficult to maintain remission as it is exacerbated by friction and trauma of the patient's daily activities. Existing topical modalities of treatment are often inadequate and show unpredictable response.
To study the efficacy and safety of a newer retinoid, tazarotene, as 0.1% cream in the treatment of palmoplantar psoriasis.
Thirty adult patients with palmo-plantar psoriasis were randomized to therapy with once daily application of topical tazarotene cream (0.1%) or once daily application of clobetasol propionate cream (0.05%) for 12 weeks. The patients were assessed every 2 weeks for improvement in Erythema, Scaling, Fissures and Induration (ESFI) score and Physicians Global Assessment Scale.
At 12 weeks, the tazarotene group showed mean ESFI reduction to 1.12 (83.2%) from 6.65 at baseline. Complete clearance was noted in 52.9% of the patients. Clobetasol propionate group showed mean ESFI reduction to 0.62 (89.1%) from 5.69 at baseline, with complete clearance in 61.5% of the patients. Differences between the two groups were statistically insignificant. Side effects observed were initial irritation (41%) in the tazarotene group and hypopigmentation (53.8%) in the steroid-treated patients.
Tazarotene is as effective as clobetasol propionate and provides a good alternative for the treatment of palmo-plantar psoriasis where hypopigmentation limits the use of clobetasol propionate cream.
掌跖银屑病是银屑病中常见的一种类型。由于患者日常活动中的摩擦和创伤会使其病情加重，因此治疗困难，维持缓解更难。现有的局部治疗方法往往效果不佳，且反应不可预测。
研究一种新型维甲酸——他扎罗汀0.1%乳膏治疗掌跖银屑病的疗效和安全性。
30例成年掌跖银屑病患者被随机分为两组，一组每天外用他扎罗汀乳膏（0.1%），另一组每天外用丙酸氯倍他索乳膏（0.05%），疗程为12周。每2周对患者的红斑、鳞屑、皲裂和硬结（ESFI）评分及医生整体评估量表的改善情况进行评估。
12周时，他扎罗汀组的ESFI评分从基线时的6.65降至1.12（降低了83.2%），52.9%的患者完全清除。丙酸氯倍他索组的ESFI评分从基线时的5.69降至0.62（降低了89.1%），61.5%的患者完全清除。两组间差异无统计学意义。观察到的副作用为他扎罗汀组最初有刺激感（41%），而类固醇治疗组有色素减退（53.8%）。
他扎罗汀与丙酸氯倍他索疗效相当，在色素减退限制了丙酸氯倍他索乳膏使用的情况下，为掌跖银屑病的治疗提供了一个很好的替代选择。
