Abidi Afroz, Ahmad Farida, Singh Satyendra K
Assistant Professor, Department of Pharmacology, Subharti Medical College , Meerut, India .
J Clin Diagn Res. 2013 Jan;7(1):100-5. doi: 10.7860/JCDR/2012/4904.2681. Epub 2012 Oct 31.
Corticosteroids are extremely useful in the treatment of inflammatory skin disorders. Topical steroid applications are the most effective treatment for all types of psoriasis.
To compare the efficacy of once daily versus alternate day application of topical steroid clobetasol propionate 0.05% (Tenovate cream®) in patients who have mild to moderate plaque psoriasis.
This study was conducted on 89 patients of plaque psoriasis, who attended the skin OPD in our hospital.
The patients who had a mild to moderate severity of plaque psoriasis were selected. Those patients who required systemic corticosteroids, those who were already undergoing any psoriasis treatment, those who had any other debilitating illness and pregnant and lactating women were excluded from the study. Eighty nine patients were enrolled for the study after taking written informed consent from them and they were randomly allocated into two groups. Two patients dropped out, one in each group and 1 of group 2 was prescribed systemic corticosteroids.Group 1- once daily application (n= 44)Group 2- alternate day application (n= 42)An objective scoring was done on the basis of the PSI (Psoriasis Severity Index) score, which was graded from 0-4. Follow ups were done in the 2nd, 4th and 6th weeks.
It was done by the Student's 't' test and ANOVA.
The results showed that there was equal improvement in both the groups in the 2nd week, since the p-value was not significant (P> 0.05), but in the 4th and 6th weeks, there was less improvement in the alternate day group (P< 0.05). An intra group comparison indicated that clobetasol was effective both in the once daily and the alternate day groups, but clinical and symptomatic improvement occurred more quickly in the once daily group after 6 weeks of assessment. Thus, it can be concluded that the alternate day application of the topical steroid clobetasol propionate cream is as effective as the once daily application in the initial 2 weeks, but by 6 weeks, its efficacy decreases. Therefore, initially, we can advocate a less frequent application of potent topical steroids but for the complete remission of the disease, the application frequency should be once daily.
皮质类固醇在炎症性皮肤病的治疗中极为有用。局部应用类固醇是治疗各类银屑病最有效的方法。
比较0.05%丙酸氯倍他索（得肤宝乳膏®）每日一次与隔日一次外用对轻至中度斑块状银屑病患者的疗效。
本研究对89例斑块状银屑病患者进行，这些患者在我院皮肤科门诊就诊。
选择轻至中度严重程度的斑块状银屑病患者。排除那些需要全身性皮质类固醇治疗的患者、已经在接受任何银屑病治疗的患者、患有任何其他衰弱性疾病的患者以及孕妇和哺乳期妇女。在获得89例患者的书面知情同意后将他们纳入研究，并随机分为两组。两名患者退出研究，每组各一名，且第二组中有一名患者被处方全身性皮质类固醇。
第一组 - 每日一次用药（n = 44）
第二组 - 隔日一次用药（n = 42）
根据银屑病严重程度指数（PSI）评分进行客观评分，评分范围为0 - 4级。在第2、4和6周进行随访。
采用学生t检验和方差分析。
结果显示，在第2周两组的改善情况相同，因为p值无统计学意义（P>0.05），但在第4周和第6周，隔日用药组的改善较少（P<0.05）。组内比较表明，丙酸氯倍他索在每日一次用药组和隔日一次用药组均有效，但在评估6周后，每日一次用药组的临床和症状改善出现得更快。因此，可以得出结论，外用0.05%丙酸氯倍他索乳膏隔日一次用药在最初2周与每日一次用药效果相同，但到6周时，其疗效降低。所以，最初我们可以提倡减少强效外用类固醇的用药频率，但为了使疾病完全缓解，用药频率应为每日一次。
