Cunningham B B, Landells I D, Langman C, Sailer D E, Paller A S
Department of Pediatrics, Northwestern University Medical School, Chicago, Illinois, USA.
J Am Acad Dermatol. 1998 Aug;39(2 Pt 1):211-5. doi: 10.1016/s0190-9622(98)70077-5.
Morphea and linear scleroderma are characterized by erythema, induration, telangiectasia, and dyspigmentation. There is no universally effective treatment. Oral calcitriol has been beneficial in the treatment of localized and extensive morphea/scleroderma, but the use of topical calcipotriene has not been reported.
The purpose of this study was to evaluate the efficacy and safety of topical calcipotriene 0.005% ointment in the treatment of localized scleroderma.
In a 3-month open-label study, 12 patients aged 12 to 38 years with biopsy-documented active morphea or linear scleroderma applied calcipotriene ointment under occlusion twice daily to plaques for 3 months. The condition of each patient had previously failed to respond to potent topical corticosteroids and, for some patients, systemic medications. Efficacy was assessed at baseline, 1 month, and 3 months. Levels of serum ionized calcium, intact parathyroid hormone, and 1,25-dihydroxyvitamin D and of random urinary calcium excretion were measured.
During the 3-month trial, the condition of all 12 patients showed statistically significant improvement in all studied features. No adverse effects were reported or detected through laboratory monitoring of mineral metabolism.
Topical calcipotriene 0.005% ointment may be an effective treatment for localized scleroderma, but double-blind placebo controlled studies are needed for confirmation.
硬斑病和线状硬皮病的特征为红斑、硬结、毛细血管扩张和色素沉着异常。目前尚无普遍有效的治疗方法。口服骨化三醇已被证明对局限性和广泛性硬斑病/硬皮病的治疗有益,但外用卡泊三烯的应用尚未见报道。
本研究旨在评估0.005%卡泊三烯软膏治疗局限性硬皮病的疗效和安全性。
在一项为期3个月的开放标签研究中,12例年龄在12至38岁之间、经活检证实为活动性硬斑病或线状硬皮病的患者,每天两次在皮损处封包外用卡泊三烯软膏,持续3个月。每位患者之前对强效外用糖皮质激素治疗无效,部分患者对全身用药也无反应。在基线、1个月和3个月时评估疗效。检测血清离子钙、完整甲状旁腺激素、1,25-二羟维生素D水平以及随机尿钙排泄量。
在为期3个月的试验中,所有12例患者的病情在所有研究指标上均显示出统计学上的显著改善。通过对矿物质代谢的实验室监测,未报告或检测到不良反应。
0.005%卡泊三烯软膏可能是治疗局限性硬皮病的有效方法,但需要双盲安慰剂对照研究加以证实。