SCALP PSORIASIS - TOPICAL ISSUES OF DIAGNOSIS AND THERAPY
L.S. Kruglova, S.N. Turbovskaya, A.A. Khotko
Central State Medical Academy of Affairs Management Department of the President of the Russian Federation, Moscow, Russia
Background. Psoriatic rashes can be localized on any areas of the skin, while the scalp is involved in the process in 80% of cases. The therapy of psoriasis patients with localization of the process on the scalp is quite difficult for clinicians and includes not only the treatment of exacerbations of dermatosis, but also maintenance therapy aimed at prolonging remission. Objective. To evaluate the efficacy and safety of using betamethasone+calcipotriol (Xamiol) fixed combination in the treatment of exacerbations and as maintenance therapy for patients with scalp psoriasis. Methods. 69 patients were under observation. In case of mild-to-moderate course of the process (Group 1), patients received monotherapy with Xamiol up to 8 weeks. In the severe course of the process (Group 2), patients used keratolytic for 15–20 minutes with occlusive dressing to eliminate the prominent scaly crusts, and after washing the keratolytic, the Xamiol gel was applied. At the second stage of the observation, patients with achieved clinical remission or significant improvement (PASI – Psoriasis Area Severity Index ≤3 points) either used Xamiol on demand (Group 3) or by intermittent scheme 1–2 times a week (Group 4) until the onset of another exacerbation. Results. In the Group 1, the PASI index was reduced by 82.7%, in the Group 2 – by 80.3%. DLQI (Dermatology Life Quality index) decreased by 80.9%, in the Group 2 – by 76.9%. In the Group 3, maintenance on-demand therapy allowed to control the process in 82.6% of patients. In Group 4, 90.6% of patients using the intermittent scheme had no negative dynamics – the PASI index persisted in the confidence interval Q1=0.2; Q3=4.8 points, which allowed the long-term control of the di-sease: PASI index <5 points, while 46.9% of patients had no exacerbations for 12 months against the background of intermittent therapy. Conclusion. Calcipotriol / betamethasone dipropionate fixed combination in the form of a gel is an effective and well-tolerated method of therapy of exacerbations and maintenance therapy for psoriasis with the localization of the process on the scalp.
Keywords: scalp psoriasis, betamethasone+calcipotriol fixed combination, Xamiol, Psoriasis Area Severity Index, Dermatology Life Quality Index
About the Autors
Corresponding author: L.S. Kruglova – MD, Prof., Head of the Department of Dermatovenereology and Cosmetology, Central State Medical Academy, Moscow, Russia; e-mail: firstname.lastname@example.org