A Comparative Clinical Evaluation of Once Daily Versus Alternate Day Application of Topical Clobetasol Propionate Cream in Psoriasis

Abstract

Background: Corticosteroids are extremely useful in the treatment of inflammatory skin disorders. Topical steroid applications are the most effective treatment for all types of psoriasis. Aims:To compare the efficacy of once daily versus alternate day application of topical steroid clobetasol propionate 0.05% (Tenovate cream®) in patients who have mild to moderate plaque psoriasis. Settings and Design:This study was conducted on 89 patients of plaque psoriasis, who attended the skin OPD in our hospital. Methods and Material:The patients who had a mild to moderate severity of plaque psoriasis were selected. Those patients who required systemic corticosteroids, those who were already undergoing any psoriasis treatment, those who had any other debilitating illness and pregnant and lactating women were excluded from the study. Eighty nine patients were enrolled for the study after taking written informed consent from them and they were randomly allocated into two groups. Two patients dropped out, one in each group and 1 of group 2 was prescribed systemic corticosteroids.Group 1-once daily application (n= 44) Group 2-alternate day application (n= 42) An objective scoring was done on the basis of the PSI (Psoriasis Severity Index) score, which was graded from 0-4. Follow ups were done in the 2nd, 4th and 6th weeks.Statistical Analysis: It was done by the Student's 't' test and ANOVA.

Topical corticosteroid therapy: clobetasol propionate 0.025%

“…Topical preparations such as corticosteroids, anthralin, coal tar and retinoids, keratolytics, phototherapy, and systemic and biological medications such as immunosuppressants and monoclonal antibodies or their combinations are used to manage psoriasis. 1 Among the available topical steroids, CP has been found to be the most potent with proven efficacy in psoriasis apart from other steroid-responsive dermatoses. It prolongs the remission rates, thus enabling intermittent treatment schedules with minimum side effects.…”

“…Owing to the anti-inflammatory, immunosuppressive, and antiproliferative effects of corticosteroids on the keratinocytes, they find a potent application in the management of several skin disorders. 1 Various factors, including body site, concentration of the drug, disease state, application method, and vehicle appropriateness, are generally considered when selecting a topical corticosteroid for the treatment of psoriasis or atopic dermatitis. 2 Clobetasol propionate (CP) 0.025% is a class I topical corticosteroid that is approved by the United States Food and Drug Administration for twice-daily application for the treatment of moderate-to-severe plaque psoriasis in patients aged 18 years or older.…”

Vulvar Dermatoses: A Primer for the Sexual Medicine Clinician

“…Corticosteroid ointments are preferred to creams because they are less irritating to the sensitive vulvar tissue, and they do not contain alcohol or other preservatives [2]. The gold standard for the ultra‐potent class of corticosteroid treatment is clobetasol propionate 0.05% ointment, prescribed topically once daily for up to 4 weeks, then every other day for 4 weeks, then twice weekly for maintenance [8,9,22–24]. Prescribing intervals can be varied based on symptoms.…”

“…The potential benefit of the use of high but not ultra‐potent TCS is minimization of side effects, including contact dermatitis, worsening of cutaneous skin infections, systemic effects, and skin atrophy. Clinicians should consider mometasone or triamcinolone as options for women who cannot tolerate clobetasol, for whom it is not effective or those at risk for side effects [11,23–27].…”

PSO-LONG: Design of a Novel, 12-Month Clinical Trial of Topical, Proactive Maintenance with Twice-Weekly Cal/BD Foam in Psoriasis

“…Various studies have demonstrated the therapeutic benefits of alternating between different topical agents on different days, such as adding a weekday nonsteroidal agent to a weekend pulse therapy regimen [ 13 – 17 ]. A common sequential regimen with topical therapy consists of applying halobetasol propionate (HP), a potent topical corticosteroid, once daily in the morning, and using calcipotriol ointment, a vitamin D analogue, once daily in the evening for approximately 1 month [ 18 ].…”