Lebwohl M
Department of Dermatology, Mount Sinai Medical Centre, New York, NY 10029-6574, USA.
J Am Acad Dermatol. 1997 Sep;37(3 Pt 2):S55-8.
Side effects of topical corticosteroids limit their long-term use. Calcipotriene/calcipotriol (Dovonex/Daivonex) ointment is not associated with any of the side effects of corticosteroids and has been shown to thicken the skin in contrast to the cutaneous atrophy caused by topical steroids.
We attempted to determine whether the addition of calcipotriene to a regimen of topical steroids results in an improved benefit/risk ratio.
Published and unpublished data on combination regimens were reviewed.
In long-term regimens for psoriasis, substituting calcipotriene for topical corticosteroids may result in a steroid-sparing effect. Conversely, topical corticosteroids may suppress the development of local cutaneous irritation that occurs in patients treated with calcipotriene ointment.
Psoriasis regimens combining calcipotriene ointment with superpotent steroids such as halobetasol ointment can result in greater improvement and fewer side effects.
局部用皮质类固醇激素的副作用限制了其长期使用。卡泊三烯/卡泊三醇（达力士）软膏与皮质类固醇激素的任何副作用均无关联，并且与局部用类固醇激素引起的皮肤萎缩相反，已证明其可使皮肤增厚。
我们试图确定在局部用类固醇激素治疗方案中添加卡泊三烯是否会改善获益/风险比。
对联合治疗方案的已发表和未发表数据进行了综述。
在银屑病的长期治疗方案中，用卡泊三烯替代局部用皮质类固醇激素可能会产生类固醇节省效应。相反，局部用皮质类固醇激素可能会抑制使用卡泊三烯软膏治疗的患者出现的局部皮肤刺激的发展。
将卡泊三烯软膏与超强效类固醇激素（如卤米松软膏）联合使用的银屑病治疗方案可带来更大的改善且副作用更少。
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