bromochloroacetic-acid and betamethasone-17-21-dipropionate

Calcipotriol and corticosteroids are established topical antipsoriatics. Previous studies have shown that combined therapy with calcipotriol and betamethasone dipropionate was more effective than monotherapy. In the present study, a recently developed combination product of calcipotriol and betamethasone dipropionate was compared with both monotherapies and the vehicle.. Twenty-five psoriatic patients were treated twice daily with the combination product, monotherapy or vehicle during 4 weeks. Skin biopsies, taken before and after treatment, were analysed using a multi-parameter flow cytometric method. Parameters of inflammation (vimentin-positive cells), normal differentiation (keratin-10-positive cells) and proliferation (cells in SG(2)M-phase) were assessed.. Flow cytometric analysis showed that the combination product turned out to be more effective in reducing inflammation compared with the other treatments. Restoration of normal differentiation was more advanced in patients treated with the combination product or betamethasone dipropionate compared to the vehicle. The highest number of normally differentiated cells was seen after use of the combination product. All treatments, except for the vehicle, decreased hyperproliferation. CONCLUSIONS This study shows that the combination product is a valuable new approach to the treatment of psoriasis.

Topics: Adult; Aged; Betamethasone; Calcitriol; Cell Cycle; Cell Division; Dermatologic Agents; Double-Blind Method; Drug Combinations; Female; Flow Cytometry; Humans; Keratin-10; Keratins; Male; Middle Aged; Psoriasis; Skin; Vimentin

Three biopsies of normal skin and 15 biopsies collected from patients with psoriasis vulgaris were analyzed for the expression of the 50 kd cytokeratin using direct immunofluorescence and ABC technique before and after local treatment with anthralin 0.1% in a petrolatum base, with 0.05% betamethasone dipropionate cream, and finally, after PUVA treatment. Antiserum against the 50 kd anti-cytokeratin reacted with tissue sections of normal skin, staining cells in the basal layer, while the psoriatic skin sections before the various treatments showed a staining concerning the whole thickness of the epidermis. After the various therapies, the 50 kd cytokeratin immunoreactivity was observed only in the basal layer of those psoriatic skin sections that showed complete clinical clearing, while it was observed in the whole thickness of psoriatic patches that did not clear. These data suggest that the normalization of the 50 kd cytokeratin expression pattern can be considered as a marker of clinical remission of psoriasis.

Topics: Administration, Topical; Adolescent; Adult; Anthralin; Anti-Inflammatory Agents; Betamethasone; Epidermis; Female; Fluorescent Antibody Technique; Glucocorticoids; Humans; Immunoenzyme Techniques; Keratins; Male; Methoxsalen; Middle Aged; Molecular Weight; Psoriasis; PUVA Therapy; Skin