Evaluation of topical 0.1% tazarotene cream in the treatment of palmoplantar psoriasis: An observer-blinded randomized controlled study

Abstract

Background:Palmoplantar psoriasis is a frequently encountered variant of psoriasis. It is difficult to treat and even more difficult to maintain remission as it is exacerbated by friction and trauma of the patient's daily activities. Existing topical modalities of treatment are often inadequate and show unpredictable response.Aim:To study the efficacy and safety of a newer retinoid, tazarotene, as 0.1% cream in the treatment of palmoplantar psoriasis.Materials and Methods:Thirty adult patients with palmo-plantar psoriasis were randomized to therapy with once daily application of topical tazarotene cream (0.1%) or once daily application of clobetasol propionate cream (0.05%) for 12 weeks. The patients were assessed every 2 weeks for improvement in Erythema, Scaling, Fissures and Induration (ESFI) score and Physicians Global Assessment Scale.Results:At 12 weeks, the tazarotene group showed mean ESFI reduction to 1.12 (83.2%) from 6.65 at baseline. Complete clearance was noted in 52.9% of the patients. Clobetasol propionate group showed mean ESFI reduction to 0.62 (89.1%) from 5.69 at baseline, with complete clearance in 61.5% of the patients. Differences between the two groups were statistically insignificant. Side effects observed were initial irritation (41%) in the tazarotene group and hypopigmentation (53.8%) in the steroid-treated patients.Conclusion:Tazarotene is as effective as clobetasol propionate and provides a good alternative for the treatment of palmo-plantar psoriasis where hypopigmentation limits the use of clobetasol propionate cream.

Iontophoretic delivery of methotrexate in the treatment of palmar psoriasis: A randomised controlled study

“…Among topical therapies, potent corticosteroids are most efficacious in the treatment of palmoplantar psoriasis, but their prolonged use may result in cutaneous side effects including atrophy and telengiectasia. Systemic medications such as methotrexate, ciclosporin and retinoids are considered when the disease is severe or when patient is not responding to topical therapies, but can be limited by adverse effects …”

Palmoplantar Psoriasis Successfully Treated with Raw Natural Honey: A Case Report

“…Systemic treatment on the other hand may include psoralen-UVA (PUVA), systemic retinoids and a combination of both, 7,8 but they often fail to give convincing results. 9 Tumor necrosis factor (TNF) antagonists are successfully being used in the treatment of psoriasis. However, unexpected side effect of TNF antagonists include the new onset or worsening of psoriatic skin lesions, [10][11][12][13][14][15] eczematous eruptions, bacterial infections, herpes simplex, cutaneous lymphomas, lichenoid eruptions, erythema multiforme, acute generalized exanthematous pustulosis and lupus erythematosus pustulosis.…”

Comparative Study of Oral Methotrexate and Acitretin in the Treatment of Palmoplantar Psoriasis

“…7 Existing topical treatments are ineffective 8 and show unpredictable response. 9 So other systemic can be used for patients with disability or added to the regimen of those who have failed topical therapy. This is the reason why this study was undertaken to compare two systemic drugs methotrexate and acitretin 10,11 in the treatment of moderate to severe palmoplantar psoriasis.…”