Effects of Calcipotriol Cream and Ointment, Clobetasol Cream and Ointment and Tretinoin Cream on the Erythemogenicity of UVB

Abstract

Various studies have shown the blocking effects of topical agents on UVB penetration, which can be used in combination with phototherapy. In this study, the photoprotective effects of 0.005% calcipotriol, 0.05% clobetasol-17-propionate, and 0.1% tretinoin, which can be used in combination with broad-band UVB, were investigated in an in vivo test. In a study group of 20 patients, phototests were performed to determine minimal erythema doses (MED) and the tests were repeated with thin (0.1 cc/25 cm2) and thick (0.3 cc/25 cm2) calcipotriol, clobetasol-17-propionate, and tretinoin in cream forms and sunscreen. After determining the MED, the test was repeated in another 20 patients with thin and thick calcipotriol and clobetasol-17-propionate in both cream and ointment forms and sunscreen. MED was increased with thin and thick applications of all agents. Moreover, the photoprotective effects of each agent increased with their thick applications compared with thin ones. The application of calcipotriol cream and ointment, clobetasol cream and ointment, and tretinoin cream, all of which can block UVB, is not recommended just before phototherapy.

A randomized, double-blind, negatively controlled pilot study to determine whether the use of emollients or calcipotriol alters the sensitivity of the skin to ultraviolet radiation during phototherapy with narrowband ultraviolet B

“…This potentially reduces UV efficacy. 7,9,12,13 These reports indicate that the use of salicylic acid 10 or calcipotriol 14 (although De Rie et al 15 concluded that this was more likely to be due to the vehicle than calcipotriol) and thicker applications of emollients 7,9,10,16 are more likely to be responsible. These reports are based on the 'in vivo' use of topical emollients prior to either BB-UVB 7,8,10,12,17 or PUVA.…”

“…13 It has also been shown in vivo that thicker applications of calcipotriol and clobetasol-17-propionate in cream and ointment forms significantly increase MED values with BB-UVB compared with thin applications immediately before UV treatment. 16 De Rie et al 15 applied calcipotriol ointment and cream in vivo the evening before, morning before, 2 h before and immediately before UVB irradiation and found that it significantly inhibits the erythema of UVB if applied immediately before UV but not prior to this. This may explain why the study by George et al 27 did not find a significant difference with the use of coconut oil used on nontreatment days to clear psoriatic plaques.…”

“…[28][29][30][31][32] When it is applied immediately before UVB, it has been shown to block transmission and is not recommended in either the cream or ointment form. 15,16 To summarize, there is contradictory evidence regarding whether emollients applied prior to phototherapy increase or decrease MED values. Most in vivo studies on this subject were performed using PUVA or BB-UVB; few studies exist looking at NB-UVB, which is most widely used in dermatology.…”

Smoothing the mosaic subclinical melanoderma by calcipotriol

“…It is likely due to direct physiological changes induced by calcipotriol on melanocytes and/or keratinocytes. An additional and surrogate photoprotective effect of the calcipotriol formulation 30 cannot be ruled out. The calcipotriol‐induced MSM smoothening effect will likely contribute to minor the risk of appearance of clinically recognizable mottled pigmentation developing on chronically photo‐exposed skin.…”

The impact of emollients on phototherapy: A review

“…Studies using crude coal tar, 18 salicylic acid, 11,18-20 petrolatum, 18,19,21 and sunflower oil 22 have demonstrated increased MED after topical application, indicating that UV radiation may be partially blocked. 18,19,23,24 The thickness of the application of the individual emollient can affect whether there is a difference in the MED. For instance, Lebwohl et al 18 demonstrated that petrolatum and white emollient cream (Eucerin, Beiersdorf, Inc, Wilton, CT) when applied as thin layer (0.4 mL/24 cm 2 of skin) had a negligible effect on MED.…”