Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand.
Dermatol Ther. 2019 Jul;32(4):e12956. doi: 10.1111/dth.12956. Epub 2019 May 20.
Topical potent corticosteroids are the mainstay of treatment for chronic hand eczema (CHE). However, there are numerous adverse effects associated with the chronic use of topical corticosteroids. Calcipotriol has been widely used in psoriasis and has been reported to achieve beneficial effects in several inflammatory diseases. This study aimed to evaluate the efficacy and safety of calcipotriol ointment compared to desoximetasone ointment in the treatment of CHE. Patch testing was performed in all recruited subjects. Then, each hand of the patient was randomly allocated for the application of either calcipotriol ointment or desoximetasone ointment twice daily for 8 weeks. Recurrence was assessed 4 weeks after discontinuation of the treatment. The Hand eczema severity index (HECSI) scores, quartile grading assessments and digital photographs were evaluated. Adverse reactions were also monitored. A total of 13 participants completed the protocol. Mean HECSI scores revealed up to a 75% reduction in both treatments (p < .001) without significant differences between the groups (p > .05). Approximately 70% of the subjects reported more than 75% improvement with calcipotriol at the end of the treatment. Mild scaling and mild dryness were the most common reactions found with calcipotriol and desoximetasone, respectively. In conclusion, calcipotriol ointment is safe and as effective as desoximetasone ointment. Calcipotriol ointment may be an alternative treatment option for CHE.
局部强效皮质类固醇是治疗慢性手部湿疹(CHE)的主要方法。然而,长期使用局部皮质类固醇会引起许多不良反应。卡泊三醇已广泛用于银屑病,并已报道在几种炎症性疾病中具有有益的效果。本研究旨在评估卡泊三醇软膏与地塞米松软膏治疗 CHE 的疗效和安全性。所有入组患者均进行斑贴试验。然后,将患者的每只手随机分配,每天两次涂抹卡泊三醇软膏或地塞米松软膏,持续 8 周。停药 4 周后评估复发情况。评估手部湿疹严重指数(HECSI)评分、四分位分级评估和数字照片。还监测不良反应。共有 13 名参与者完成了方案。平均 HECSI 评分显示,两种治疗方法均可使评分降低 75%以上(p<0.001),但两组之间无显著差异(p>0.05)。治疗结束时,约 70%的患者报告说卡泊三醇的改善程度超过 75%。卡泊三醇和地塞米松最常见的不良反应分别是轻度脱屑和轻度干燥。总之,卡泊三醇软膏安全且与地塞米松软膏同样有效。卡泊三醇软膏可能是 CHE 的一种替代治疗选择。