calcipotriene and Foot-Dermatoses

Topics: Calcitriol; Dermatologic Agents; Diagnosis, Differential; Foot Dermatoses; Hand Dermatoses; Humans; Keratolytic Agents; Psoriasis; PUVA Therapy

Topical calcipotriene ointment has been approved for the treatment of plaque-type psoriasis.. This article explores the possible use of topical calcipotriene ointment in the treatment of nail and intertriginous psoriasis, palmoplantar and pustular psoriasis, Reiter's syndrome, pityriasis rubra pilaris, and disorders of keratinization.. The recent literature is reviewed.. Recent reports suggest that certain ichthyoses (particularly the hyperproliferative variants) and keratodermas may respond to topical calcipotriene ointment. The activity of calcipotriene relates to a dose-dependent decrease in proliferation and an increase in terminal differentiation of keratinocytes.. Patients with other disorders characterized by epidermal hyperproliferation may also be candidates for treatment. The use of calcipotriene in treating congenital hyperproliferative disorders is limited by the theoretical risk of hypercalcemia from absorption of the drug after application to extensive areas of skin.

Topics: Administration, Topical; Arthritis, Reactive; Calcitriol; Cell Differentiation; Cell Division; Dermatologic Agents; Dose-Response Relationship, Drug; Foot Dermatoses; Hand Dermatoses; Humans; Hypercalcemia; Ichthyosis; Keratinocytes; Keratosis; Nail Diseases; Ointments; Pityriasis Rubra Pilaris; Psoriasis; Skin Absorption; Skin Diseases

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Betamethasone; Calcitriol; Child; Child, Preschool; Dermatologic Agents; Drug Combinations; Female; Foot Dermatoses; Hand Dermatoses; Humans; Male; Middle Aged; Ointments; Onycholysis; Severity of Illness Index; Young Adult

Thirty-nine patients with a clinical diagnosis of palmoplantar psoriasis [23 (58%) males and 16 (42%) females] were included in this study with the aim of evaluating the efficacy of occlusive calcipotriol 50 micrograms/mg ointment vs. nonocclusive therapy. Patients were randomized to either twice-weekly overnight calcipotriol ointment under occlusion or twice-daily topical nonocclusive application of the same ointment for 6 weeks. The effect of treatment was assessed on the basis of a psoriasis signs score for erythema, thickness and scaliness, which was graded from 0 (absent) to 4 (most severe) at the first visit, after 2 weeks and at the end of treatment. Analysis of our results showed that twice-weekly occlusive calcipotriol ointment was as effective as the twice-daily application. The mean total score at baseline was 6 for the occlusive group and 6.1 for the nonocclusive group. The score decreased to 1.5 in both groups at the end of treatment. No significant adverse effects were reported by patients or investigators. We conclude that occlusive calcipotriol ointment is effective in the treatment of palmoplantar psoriasis and may produce even better results with more frequent use, such as application on alternate days.

Topics: Administration, Topical; Adult; Calcitriol; Dermatologic Agents; Female; Foot Dermatoses; Hand Dermatoses; Humans; Male; Matched-Pair Analysis; Occlusive Dressings; Ointments; Psoriasis; Time Factors

Topics: Administration, Cutaneous; Calcitriol; Child; Dermatitis; Dermatologic Agents; Female; Foot Dermatoses; Hamartoma; Humans; Infant; Leg Dermatoses; Male; Skin Diseases