calcipotriene and Dermatomycoses

This article takes a historical perspective and makes an assessment of current and future changes in the treatment of psoriasis and cutaneous fungal infections. Both medical and physical therapies in the management of psoriasis are reviewed and an assessment of the new approaches, compared with the old, is made. The vexing problem of cutaneous fungal infections is considered and the newer topical preparations are reviewed. With the arrival of these newer products improved outcomes for psoriasis and cutaneous fungal infections are being found.

Topics: Antifungal Agents; Calcitriol; Dermatologic Agents; Dermatomycoses; Female; Humans; Male; Psoriasis; PUVA Therapy; Treatment Outcome

To investigate if there is a synergy between the presence of the Malassezia yeasts and the adverse reaction during treatment of scalp psoriasis with calcipotriol scalp solution, patients were treated with itraconazole to reduce the number of Malassezia yeasts. This study was a double-blind, placebo-controlled parallel group study between oral itraconazole or placebo for 8 weeks in patients with scalp psoriasis. After 2 weeks, calcipotriol scalp solution was applied twice daily for 6 weeks. Altogether 137 patients, 67 in the itraconazole group and 70 in the placebo group, comprised the intention-to-treat population. There were 13 (19.4%) patients with local skin irritation in the itraconazole group compared to 33 (47.1%) in the placebo group (p < 0.001). The skin irritation was significantly lower in patients with a low number of cultured Malassezia yeasts (p = 0.017). Thus, when Malasessia was eliminated or the numbers reduced, the irritation produced by calcipotriol was significantly diminished.

Topics: Administration, Oral; Administration, Topical; Adolescent; Adult; Aged; Calcitriol; Dermatomycoses; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Drug Synergism; Female; Follow-Up Studies; History, 18th Century; Humans; Itraconazole; Logistic Models; Malassezia; Male; Middle Aged; Probability; Psoriasis; Risk Assessment; Scalp Dermatoses; Severity of Illness Index; Treatment Outcome