Régnier Antonia, Trüeb Ralph M
Center for Dermatology and Hair Diseases, Bahnhofplatz 1A, 8304, Wallisellen, Switzerland.
Dermatol Ther (Heidelb). 2022 Sep;12(9):2181-2188. doi: 10.1007/s13555-022-00785-z. Epub 2022 Aug 20.
Scalp psoriasis is one of the most common and challenging manifestations of plaque psoriasis for general practitioners, dermatologists, and patients, as successful topical management requires the choice of effective ingredients, an appropriate formulation, and clear application instructions to patients. To date, only limited experience is available for the calcipotriol (50 μg/g)/betamethasone dipropionate (0.5 mg/g) aerosol foam formulation (Cal/BD foam) in the treatment of scalp psoriasis.
In this Swiss real-world patient case series, we asked 10 consecutive patients with active scalp psoriasis to apply the Cal/BD foam once daily before bedtime for a period of 4 weeks. Clear application and rinse-off instructions were provided.
A total of 10 consecutive adult patients were treated between April and May 2019. Two patients suffered from mild, five from moderate, and three from severe scalp psoriasis. In eight out of the 10 patients, scalp psoriasis was the only manifestation of disease. All patients had received previous topical treatments, mainly topical corticosteroids (TCS), tar shampoo, and salicylic acid. After 4 weeks of treatment with Cal/BD foam, the scalp psoriasis improved in all 10 patients by ≥ 2 points on a 5-point severity assessment scale. Eight out of 10 patients achieved clear/almost clear skin after 4 weeks of treatment, with no further keratolytic treatments needed. Adverse events were not observed in any of the patients. Overall, patients were very satisfied with the ease of use, the efficacy, and the safety of the Cal/BD foam.
Our case series confirms that Cal/BD foam is a rapid, effective, and convenient treatment for localized scalp psoriasis in a nonselected real-world patient cohort refractory to TCS or other local treatments. Clear application instructions are crucial for treatment success and cosmetic acceptance, however.
头皮银屑病是斑块状银屑病最常见且具挑战性的表现之一，对于全科医生、皮肤科医生及患者来说都是如此，因为成功的局部治疗需要选择有效的成分、合适的剂型，并向患者提供清晰的使用说明。迄今为止，关于卡泊三醇（50μg/g）/二丙酸倍他米松（0.5mg/g）气雾剂泡沫制剂（钙泊三醇/倍他米松泡沫）治疗头皮银屑病的经验有限。
在这个瑞士的真实世界患者病例系列中，我们让10例连续的活动性头皮银屑病患者在睡前每天使用一次钙泊三醇/倍他米松泡沫，持续4周。提供了清晰的使用和冲洗说明。
2019年4月至5月期间共治疗了10例连续的成年患者。2例为轻度头皮银屑病，5例为中度，3例为重度。10例患者中有8例，头皮银屑病是唯一的疾病表现。所有患者之前都接受过局部治疗，主要是外用糖皮质激素（TCS）、焦油洗发水和水杨酸。用钙泊三醇/倍他米松泡沫治疗4周后，10例患者的头皮银屑病在5分制严重程度评估量表上均改善了≥2分。10例患者中有8例在治疗4周后达到皮肤清除/几乎清除，无需进一步的角质剥脱治疗。所有患者均未观察到不良事件。总体而言，患者对钙泊三醇/倍他米松泡沫的易用性、疗效和安全性非常满意。
我们的病例系列证实，钙泊三醇/倍他米松泡沫对于对TCS或其他局部治疗无效的非选择真实世界患者队列中的局限性头皮银屑病是一种快速、有效且方便的治疗方法。然而，清晰的使用说明对于治疗成功和美容接受度至关重要。
