A comparative study of once daily tazarotene versus combination of tazarotene and betamethasone valerate in the treatment of plaque psoriasis

Humaira Afreen, A.K.M Shariful Islam, Mohd. Nurul Alam, Farzana Afroz, Tahmina Sultana

Abstract


Objective To compare the efficacy of once daily tazarotene and combination of tazarotene and betamethasone valerate in the treatment of plaque psoriasis.

 

Materials and Methods A clinical trial was carried out for the duration of six months from November 2012 to April 2013 in the department of Dermatology and Venereology, Sir Salimullah Medical College, Mitford hospital, Dhaka. Patients who presented with mild to moderate plaque psoriasis, aged 18 to 60 years, were included in the study. In group A, 30 patients applied only tazarotene (0.1%) once in the evening and in group B, 30 patients applied once daily betamethasone in the morning plus tazarotene (0.1%) in the evening. The effectiveness of treatment was assessed at baseline and at the end of 4th week and 12th week of the study.

 

Results The mean PASI Score in group A and group B reduced from 17.61±2.23, 19.16±2.37 respectively to 9.24±1.09 and 4.92±0.51 (p<0.001), after 3 months of treatment.  In group A and group B, 47.48% and 74.24% reduction of PASI was observed respectively after treatment. In Group A, among 30 patients, 21 (70%) had adverse effects. The most common adverse effects were burning 7(33.3%), irritation 4(19.0%), dry skin and pruritus 3(14.3%), fissuring, bleeding and worsening of psoriasis 2(9.5%). In Group B, among 30 patients, 10 (33.3%) experienced adverse effects. The most common adverse effects were burning 4(40%), irritation 3(30%), dry skin and pruritus 2(20.0%).

 

Conclusion Topical tazarotene seems to be significant and well tolerated agent for the treatment of plaque type psoriasis. But combination of tazarotene and betamethasone valerate proved to be more significant and well tolerated in terms of effectiveness and safety measures.

 


Keywords


Psoriasis, tazarotene, betamethasone, PASI

Full Text:

PDF

References


James WD, Berger TG, Elston DM. Psoriasis: Andrews' Diseases of the Skin. Clinical Dermatology. 10th ed. Canada: Saunders Elsevier; 2006: p.193-201.

Wolff K, Goldsmith LA, Katz SI. Psoriasis. Dermatology in General Medicine. 7th ed. USA: McGraw Hill; 2008: p.169-193.

Gelfard JM, Feldman SR, Stern RS. et al. Determinants of quality of life in patients with psoriasis; Study from the US population. J Am Acad Dermatol 2004; 51: 704.

Rapp SR, Feldman SR, Exam ML. et al. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol 1999; 41: 401.

Henseler T, Christophers E. Disease concomitance in Psoriasis. J Am Acad Dermatol 1995; 32: 982-6.

Gelfard JM, Neiman AN, et al. Risk of myocardial infarction in patients with psoriasis. JAMA 2006; 296: 1735-41.

Gelfard JM, Gladman DD, Mease PJ, et al. Epidemiology of psoriatic arthritis in the population of United States. J Am Acad Dermatol 2005; 53: 573.

Lebwohl M. A clinician's paradigm in the treatment of psoriasis. J Am Acad Dermatol. 2005; 53: 559-69.

Liem WH, McCullough JL, Weinstein GD. Is topical therapy effective for psoriasis? Results of a survey of US dermatologists 1992; 40: 495.

Stoughton RB, Cornell RI. Review of super-potent topical corticosteroids Semin Dermatol 1987; 6: 72-6.

Johns AM, Bower BD. Wasting of napkin area after repeated use of fluorinated steroid ointment. Br Med J 1970; 1: 347.

Stenmovic DV. Corticosteroid involved atrophy of the skin with telangiectasia: A clinical and experimental study. Br J Dermatol 1972; 87: 548-56.

Lowe NJ. Systemic retinoid therapy. In: Weinstein GD, Gottlieb AB, eds. Therapy of moderate to severe Psoriasis. Portland, Ore: National Psoriasis Foundation; 1993: 94-105.

Nesher G, Zuckner J. Rheumatologic complications of vitamin A and retinoids. Semin Arthritis Rheum 1995; 24: 291-296.

Mitchell AA. Oral retinoids: what should the prescriber know about their teratogenic hazards among women of child-bearing potential? Drug Saf 1992; 7: 79-85.

Esgleyes-Ribot T, Chandraratna RA, et al. Response of psoriasis to a new topical retinoid, tazarotene. J Am Acad Dermatol. 1994; 30: 581-590.

Chandraratna RAS. Tazarotene- first of a new generation of receptor-selective retinoids. Br J Dermatol 1996; 135: 18-25.

Esgleyes-Ribot T, Chandraratna RAS, et al. Response of psoriasis to a new topical retinoid. J Am Acad Dermatol 1994; 30: 581-90.

Menter A. Pharmacokinetics and safety of Tazarotene. J Am Acad Dermatol 2000; 43: S31-5.

Schon, MP, Boehncke WH, 2005, 'Psoriasis' New England Journal of Medicine, Vol. 352, pp. 1899-1912.

Inderjeet, K, Bhusian K, et al. 'Epidemiology of Psoriasis in a Clinic from North India'. Indian J Dermatol Venereol Leprol 1986; 52(4): 208-212.

Christophers E, Mrowietz U. 1995, 'The inflammatory infiltrate in psoriasis'. Clin Dermatol 1995; 13(2): 131-5.

Puri N, Mahajah B, et al. 'Clinical Evaluation of Different Therapeutic Modalities In Psoriasis by PASI Score', Dermatol online 2013; 4(1): 16-22.

Dando TM, Wellington K. Topical tazarotene: a review of its use in the treatment of plaque psoriasis. Am J Clin Dermatol 2005; 6(4): 255-72.


Refbacks

  • There are currently no refbacks.


ISSN: 1560-9014