calcipotriene and Hand-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

Though topical corticosteroid is a standard treatment for chronic hand eczema (CHE), it can cause many adverse effects. Topical calcipotriol and monochromatic 308-nm excimer light (MEL) are new alternative therapies for several dermatoses, including CHE.. This study aims to compare the efficacy of the combination of MEL and topical calcipotriol versus topical calcipotriol alone.. One hand of the participants was randomly assigned to be irradiated with MEL twice weekly and topical calcipotriol applied twice daily while the other hand was assigned to receive only topical calcipotriol twice daily for 8 weeks. Then, only petrolatum ointment was applied during the 4-week follow-up period. Hand Eczema Severity Index (HECSI) and modified Total Lesion Symptom Score were assessed by a blinded investigator, and a visual analogue scale score of itching symptoms was graded by the participants.. In total, 36 hands from 18 subjects completed the protocol. On the combination-treated sides, the mean HECSI score was significantly reduced by 25% (p = 0.015) from the 4th week. Then, it was gradually decreased to 57 and 65% (p < 0.001) at the 8th week and at the follow-up visit, respectively. For the monotherapy-treated sides, the mean HECSI score was reduced to 41% (p = 0.001) and 49% (p < 0.001) at the 8th and 12th week, accordingly. At the end of the treatment period, itching scores were significantly decreased by around 64% (p < 0.001) and 51% (p = 0.002) on the combination-treated and the monotherapy-treated sides. No serious and persistent adverse reactions were found.. The combined MEL and topical calcipotriol may be considered as an alternatively effective treatment for CHE.

Topics: Administration, Topical; Adult; Aged; Calcitriol; Chronic Disease; Dermatologic Agents; Eczema; Female; Hand Dermatoses; Humans; Lasers, Excimer; Low-Level Light Therapy; Male; Middle Aged; Treatment Outcome

Topical potent corticosteroids are the mainstay of treatment for chronic hand eczema (CHE). However, there are numerous adverse effects associated with the chronic use of topical corticosteroids. Calcipotriol has been widely used in psoriasis and has been reported to achieve beneficial effects in several inflammatory diseases. This study aimed to evaluate the efficacy and safety of calcipotriol ointment compared to desoximetasone ointment in the treatment of CHE. Patch testing was performed in all recruited subjects. Then, each hand of the patient was randomly allocated for the application of either calcipotriol ointment or desoximetasone ointment twice daily for 8 weeks. Recurrence was assessed 4 weeks after discontinuation of the treatment. The Hand eczema severity index (HECSI) scores, quartile grading assessments and digital photographs were evaluated. Adverse reactions were also monitored. A total of 13 participants completed the protocol. Mean HECSI scores revealed up to a 75% reduction in both treatments (p < .001) without significant differences between the groups (p > .05). Approximately 70% of the subjects reported more than 75% improvement with calcipotriol at the end of the treatment. Mild scaling and mild dryness were the most common reactions found with calcipotriol and desoximetasone, respectively. In conclusion, calcipotriol ointment is safe and as effective as desoximetasone ointment. Calcipotriol ointment may be an alternative treatment option for CHE.

Topics: Administration, Cutaneous; Adult; Aged; Calcitriol; Chronic Disease; Dermatologic Agents; Desoximetasone; Double-Blind Method; Eczema; Female; Glucocorticoids; Hand Dermatoses; Humans; Male; Middle Aged; Ointments; Prospective Studies; Treatment Outcome

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: Acrodermatitis; Administration, Cutaneous; Aged; Anti-Inflammatory Agents; Calcitriol; Clobetasol; Diagnosis, Differential; Fingers; Hand Dermatoses; Humans; Male; Nails, Malformed

Acrodermatitis continua of Hallopeau (ACH) is a rare type of pustular psoriasis affecting the digits. We report on a 43-year-old female patient who had been suffering from ACH for more than 20 years. Despite the fact that the disease was localized on one finger during the whole period, several topical and systemic treatments resulted in only temporary or partial improvement of the lesion. Although the monotherapies with calcipotriol and tacrolimus ointments gave no satisfying results in the long-term management of the disease, the combination of both agents led to a continuous improvement of the patient's skin condition.

Topics: Acrodermatitis; Administration, Cutaneous; Adult; Calcitriol; Dermatologic Agents; Drug Combinations; Female; Hand Dermatoses; Humans; Immunosuppressive Agents; Ointments; Psoriasis; Tacrolimus

Topics: Adult; Calcitriol; Diagnostic Errors; Follow-Up Studies; Hand Dermatoses; Humans; Hyperpigmentation; Male; Minocycline; Papilloma; Regional Blood Flow; Skin; Skin Diseases, Vascular; Skin Neoplasms; Treatment Failure

Topics: Adult; Calcitriol; Dermatologic Agents; Female; Hamartoma; Hand Dermatoses; Humans