calcipotriene and Pityriasis-Rubra-Pilaris

Pityriasis rubra pilaris is a syndrome of unknown etiology. Six distinct clinical types have been described in infancy and adulthood. Oral retinoids have proven their efficacy. Emollients and topical calcipotriol may improve the clinical presentation.

Topics: Administration, Oral; Administration, Topical; Adult; Calcitriol; Child; Dermatologic Agents; Diagnosis, Differential; Emollients; Humans; Pityriasis Rubra Pilaris; Retinoids

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

From a clinical, histological and therapeutic point of view, psoriasis and pityriasis rubra pilaris share important characteristics. Recently, calcipotriol has been shown to be an effective treatment in psoriasis, and we report three patients with pityriasis rubra pilaris who showed a favourable response to topical therapy with calcipotriol. In one case, analysis of markers for epidermal growth, differentiation and inflammation revealed reduction of suprabasal expression of keratin 16, and the number of T lymphocytes, monocytes and macrophages. It is of interest that a reduction of the recruitment of cycling epidermal cells, which is a consistent response pattern during treatment of psoriasis, was not observed during treatment of pityriasis rubra pilaris.

Topics: Administration, Topical; Aged; Aged, 80 and over; Calcitriol; Child; Humans; Immunohistochemistry; Keratins; Macrophages; Male; Middle Aged; Monocytes; Pityriasis Rubra Pilaris; T-Lymphocytes

Topics: Aged; Calcitriol; Humans; Male; Pityriasis Rubra Pilaris