Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.
Department of Dermatology, Seoul National University Hospital, Seoul, South Korea.
J Dermatol. 2024 Jul;51(7):1010-1016. doi: 10.1111/1346-8138.17253. Epub 2024 May 8.
Small plaque psoriasis is the typical form of chronic plaque psoriasis affecting adults in South Korea. The effectiveness of calcipotriol/betamethasone dipropionate (Cal/BD) aerosol foam for large and small psoriasis plaques has not previously been examined. We performed a post hoc analysis of a recent, 4-week observational study of Cal/BD aerosol foam use in routine clinical practice in South Korea. Investigator Global Assessment response ([IGA] 0/1 at week 4), Patient Global Assessment response ([PaGA] 0/1 at week 4), change in Psoriasis Area and Severity Index (PASI), changes in psoriasis symptom scores, change in the Dermatology Life Quality Index (DLQI), and the proportion of patients achieving DLQI ≤5 were analyzed for patients with small (≤5 cm; n = 131) or large (>5 cm; n = 35) baseline plaque size. IGA response rates were similar for patients with small and large plaques (59.5% and 51.4% respectively). Similarly, there was no significant difference between the small and large groups in mean change in PASI (-2.20 vs -3.34), the proportions of patients with DLQI ≤5 (62.3% vs 54.3%) or PaGA 0/1 (29.2% vs 40.0%). Mean improvements in DLQI (-4.04 vs -6.20) and in psoriasis symptoms including itching (-1.50 vs -2.83), sleep loss (-0.67 vs -1.89), dryness (-1.57 vs -2.97), scaling (-1.21 vs -3.57), and redness (-1.17 vs -3.11) were greater in patients with large plaques than those with small plaques. Itching and DLQI differences were not statistically significant after adjustment for baseline characteristics. Stratification by body surface area affected eliminated statistically significant differences between the groups for most outcomes. In conclusion, this analysis suggests that Cal/BD aerosol foam is an effective, well-accepted treatment for adult patients with the small plaques typical of chronic plaque psoriasis in South Korea, as well as for those with large plaques.
小斑块型银屑病是影响韩国成年人的慢性斑块型银屑病的典型形式。卡泊三醇/倍他米松二丙酸酯（Cal/BD）气雾剂泡沫在大、小银屑病斑块中的疗效以前尚未被研究过。我们对最近在韩国进行的一项为期 4 周的 Cal/BD 气雾剂泡沫常规临床实践观察研究进行了事后分析。研究者全球评估应答（第 4 周时为 0/1）、患者全球评估应答（第 4 周时为 0/1）、银屑病面积和严重程度指数（PASI）的变化、银屑病症状评分的变化、皮肤病生活质量指数（DLQI）的变化以及达到 DLQI≤5 的患者比例，分别对基线斑块大小为小（≤5cm；n=131）或大（>5cm；n=35）的患者进行分析。小斑块和大斑块患者的 IGA 应答率相似（分别为 59.5%和 51.4%）。同样，小斑块组和大斑块组在 PASI 平均变化（-2.20 与-3.34）、达到 DLQI≤5 的患者比例（62.3%与 54.3%）或 PaGA 0/1（29.2%与 40.0%）方面无显著差异。DLQI 的平均改善（-4.04 与-6.20）以及瘙痒（-1.50 与-2.83）、睡眠损失（-0.67 与-1.89）、干燥（-1.57 与-2.97）、脱屑（-1.21 与-3.57）和红斑（-1.17 与-3.11）等银屑病症状的改善在大斑块患者中比小斑块患者更大。调整基线特征后，瘙痒和 DLQI 差异无统计学意义。按受累体表面积分层后，两组间大多数结局的差异无统计学意义。总之，该分析表明，Cal/BD 气雾剂泡沫是一种有效的、被广泛接受的治疗方法，可用于治疗韩国成人慢性斑块型银屑病患者的小斑块，也可用于治疗大斑块患者。
