Henry Ford Medical Center, Detroit, Michigan, USA.
Psoriasis Treatment Center of Central New Jersey, East Windsor, USA.
Cutis. 2020 Feb;105(2):97-102;E1.
Patients consider pruritus and scaling to be the most bothersome symptoms of psoriasis. Psoriatic plaques on the knees and elbows are widely considered difficult to treat because of the thicker stratum corneum, which reduces skin hydration and topical absorption. Betamethasone dipropionate (BD) spray 0.05% is a topical steroid with demonstrated efficacy in treating plaque psoriasis. Post hoc analyses of 2 phase 3 trials were done to assess the efficacy of BD spray in relieving the symptom of itching and improving the signs of erythema, scaling, and plaque elevation on plaques located on the knees and elbows vs its vehicle and an augmented BD (AugBD) lotion 0.05%. Betamethasone dipropionate spray reduced the incidence of pruritus, with approximately half of patients who reported itching at baseline showing complete itch relief by day 4. Betamethasone dipropionate spray also reduced the signs of psoriasis on knee and elbow plaques in more patients than AugBD lotion at day 4, though the differences were not statistically significant. Efficacy was similar between the 2 formulations on days 8 and 15. Betamethasone dipropionate spray rapidly relieved2 of the most bothersome symptoms of psoriasis and improved psoriatic signs in hard-to-treat knee and elbow plaques.
患者认为瘙痒和鳞屑是银屑病最恼人的症状。由于角质层较厚，会降低皮肤的水分和局部吸收，因此膝关节和肘关节的银屑病斑块被广泛认为难以治疗。倍他米松二丙酸酯（BD）喷雾剂 0.05%是一种局部皮质类固醇，已被证明在治疗斑块状银屑病方面具有疗效。对 2 项 3 期临床试验进行了事后分析，以评估 BD 喷雾剂在缓解瘙痒症状和改善位于膝关节和肘关节上的斑块的红斑、鳞屑和斑块隆起的体征方面的疗效，与赋形剂和增强型 BD（AugBD）乳液 0.05%相比。BD 喷雾剂可降低瘙痒的发生率，约有一半在基线时报告瘙痒的患者在第 4 天完全缓解瘙痒。与 AugBD 乳液相比，BD 喷雾剂在第 4 天也能使更多的患者膝关节和肘关节斑块上的银屑病症状得到改善，尽管差异无统计学意义。在第 8 天和第 15 天，两种制剂的疗效相似。BD 喷雾剂迅速缓解了银屑病最恼人的两种症状，并改善了治疗困难的膝关节和肘关节斑块的银屑病体征。
