Dall'Oglio Federica, Verzì Anna Elisa, Guglielmi Giulia, Zappulla Sabrina, Micali Giuseppe
Dermatology Clinic, University of Catania, Catania, Italy.
Psoriasis (Auckl). 2024 Nov 15;14:135-142. doi: 10.2147/PTT.S465545. eCollection 2024.
Psoriasis affecting sensitive areas and folds represents a therapeutic challenging as the skin in these areas may be more prone to local pharmacological side effects. The aim of this prospective, randomized, open-label study was to evaluate the efficacy and tolerability of a new prescription emollient device (PED) as a cream containing primarily furfuryl palmitate (antioxidant, anti-inflammatory, soothing), tocopherol (antioxidant), and dimethicone (occlusive) for the treatment of psoriasis localized to difficult-to-treat areas.
Thirty patients (14M/16F) with mild-to-moderate psoriasis of sensitive areas such as face, vulva, scrotum, pubic area, neck (15 cases), and of folds including axillary fossa, intergluteal cleft, submammary/inguinal folds, and umbilicus (15 cases) were consecutively enrolled and instructed to apply the cream twice daily for 8 weeks. Efficacy was assessed at baseline, at 4 and 8 weeks by measuring the degree of erythema, scaling, infiltration and pruritus using clinical, instrumental and subject-completed Visual Analog Scale (VAS) assessments. At the end of the study, the Investigator Global Assessment (IGA) of efficacy was performed.
Statistically significant reductions in erythema, scaling, infiltration, and itching scores were observed at 8 weeks compared to baseline. In addition, IGA efficacy score was clear in 7 cases and almost clear in 4 cases for psoriasis of sensitive areas and clear in 5 cases and almost clear in 4 cases for psoriasis of folds. No relevant side effects were observed in any of the groups.
Our results suggest that the tested PED containing antioxidant, anti-inflammatory, soothing and occlusive agents may represent a valid therapeutic option for mild-to-moderate psoriasis of sensitive areas and folds in monotherapy or in combination with pharmacological agents if necessary.
银屑病累及敏感部位和褶皱部位时,治疗颇具挑战性,因为这些部位的皮肤可能更容易出现局部药物副作用。这项前瞻性、随机、开放标签研究的目的是评估一种新型处方润肤装置(PED)作为一种主要含有棕榈糠酯(抗氧化、抗炎、舒缓)、生育酚(抗氧化剂)和二甲硅油(封闭剂)的乳膏,用于治疗局限于难治疗部位的银屑病的疗效和耐受性。
连续纳入30例患者(14例男性/16例女性),他们患有轻度至中度银屑病,累及面部、外阴、阴囊、耻骨区、颈部等敏感部位(15例),以及腋窝、臀间裂、乳房下/腹股沟褶皱和脐部等褶皱部位(15例),并指导他们每天两次涂抹该乳膏,持续8周。在基线、第4周和第8周时,通过临床、仪器和受试者完成的视觉模拟量表(VAS)评估来测量红斑、脱屑、浸润和瘙痒程度,以评估疗效。在研究结束时,进行研究者整体疗效评估(IGA)。
与基线相比,第8周时红斑、脱屑、浸润和瘙痒评分在统计学上有显著降低。此外,对于敏感部位银屑病,IGA疗效评分为清除的有7例,几乎清除的有4例;对于褶皱部位银屑病,IGA疗效评分为清除的有5例,几乎清除的有4例。在任何一组中均未观察到相关副作用。
我们的结果表明,所测试的含有抗氧化、抗炎、舒缓和封闭剂的PED可能是轻度至中度敏感部位和褶皱部位银屑病单一疗法或必要时与药物联合治疗的有效选择。