Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Dermatology Center of Aversa (ASL CE), Aversa, Italy.
J Eur Acad Dermatol Venereol. 2019 Jul;33(7):1312-1315. doi: 10.1111/jdv.15488. Epub 2019 Mar 7.
BACKGROUND/OBJECTIVE: Although 40% of psoriasis patients reported skin pain, this symptom is often underestimated. A new formula of calcipotriol plus betamethasone dipropionate (Cal/BD) has been recently approved for psoriasis treatment. Therefore, we aimed to evaluate the efficacy of Cal/BD aerosol foam on skin pain of patients with plaque psoriasis.
A real-life 4-week prospective, open study on Cal/BD aerosol foam (not compared to vehicle or emollient cream) was performed in adult psoriasis patients attending three Dermatology units located in Campania region, Italy, between March and October 2018. Inclusion criteria were a history of skin pain over the last week and psoriatic involvement of the palmar area. Before (t0) and after a course of once daily application of Cal/BD aerosol foam for 4 weeks (t1), the following items were evaluated: Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA) index of target plaque on palmar region, subjective skin pain features through Pain Qualities Assessment Scale questionnaire and skin pain threshold measured by pressure digital algometer at palmar psoriatic plaques.
Seventy-five patients (43 male, mean age of 43.2 years) were enrolled. After 4 weeks of therapy with Cal/BD aerosol foam, a significant improvement in both PASI (mean: 6.5 ± 2.1 at t0 vs. 2.3 ± 1.6 at t1) and palmar plaques PGA (mean: 3.6 at t0 vs. 1.7 at t1) was observed (P < 0.001). The mean intensity score of skin pain decreased from 7.6 to 1.3 (P < 0.001); among skin pain qualities, intense, sensible, aching and unpleasant showed the highest rate of reduction (t0-t1: 6.3, 6.3, 6.1 and 5.8, respectively). Pain threshold of palmar skin lesions increased at t1.
Our real-life study suggested that Cal/BD aerosol foam may represent a valid topical anti-psoriatic treatment, not only improving skin lesions, but also relieving cutaneous pain, thus contributing to ameliorate patients' quality of life.
背景/目的：尽管 40%的银屑病患者报告有皮肤疼痛，但这种症状往往被低估了。一种新的卡泊三醇倍他米松（Cal/BD）配方最近被批准用于治疗银屑病。因此，我们旨在评估卡泊三醇倍他米松气雾剂泡沫在斑块状银屑病患者皮肤疼痛中的疗效。
2018 年 3 月至 10 月期间，在意大利坎帕尼亚地区的三个皮肤科单位，对接受卡泊三醇倍他米松气雾剂泡沫（未与载体或乳膏剂比较）治疗的成年银屑病患者进行了为期 4 周的前瞻性、开放性真实生活研究。纳入标准为过去一周内有皮肤疼痛史和手掌部位的银屑病斑块。在每日一次使用卡泊三醇倍他米松气雾剂泡沫治疗 4 周前（t0）和后（t1），评估以下项目：银屑病面积和严重程度指数（PASI）、手掌部位目标斑块的医生总体评估（PGA）指数、通过疼痛质量评估量表问卷评估的主观皮肤疼痛特征以及手掌银屑病斑块的皮肤疼痛阈值。
共纳入 75 例患者（43 例男性，平均年龄 43.2 岁）。使用卡泊三醇倍他米松气雾剂泡沫治疗 4 周后，PASI（t0：6.5 ± 2.1；t1：2.3 ± 1.6）和手掌斑块 PGA（t0：3.6；t1：1.7）均显著改善（P < 0.001）。皮肤疼痛的平均强度评分从 7.6 降至 1.3（P < 0.001）；在皮肤疼痛性质中，剧烈、敏感、酸痛和不愉快的改善率最高（t0-t1：6.3、6.3、6.1 和 5.8）。手掌皮肤病变的疼痛阈值在 t1 时增加。
我们的真实生活研究表明，卡泊三醇倍他米松气雾剂泡沫可能是一种有效的局部抗银屑病治疗方法，不仅能改善皮肤病变，还能缓解皮肤疼痛，从而改善患者的生活质量。
