Proactive treatment with calcipotriol reduces recurrence of plaque psoriasis

Abstract

Topical calcipotriol is a widely used treatment for plaque-type psoriasis worldwide, and has been shown to improve psoriatic plaques as well as very potent corticosteroids. However, there remains the practical question of whether calcipotriol application should continue on healed pigmentation/depigmentation associated with psoriatic plaques. Therefore, we conducted a pilot clinical study to answer this question. Plaque-type psoriatic patients not receiving systemic treatment were enrolled and treated with calcipotriol for 8 weeks (stage I) to achieve maximum effect. The patients were then divided into two groups: group A continued to apply calcipotriol to the entirety of the previous lesion (including pigmentation/depigmentation) regardless of whether skin was healed or not, while group B applied calcipotriol to the remaining lesion only. Patients were followed for 12 weeks (stage II) and dates of plaque recurrence were recorded. A total of 29 patients (13 men, 16 women) were enrolled. During stage I, reductions in scores for redness, induration and scale occurred in 40%, 47% and 55% of patients, respectively. After stage II was completed, group A (n = 19) showed a significantly better Kaplan-Meier curve of non-recurrence than group B (n = 8, P < 0.01). The mean non-recurrence duration was 76.8 ± 11.8 in group A and 35.0 ± 12.0 in group B. Our study showed that applying topical calcipotriol on seemingly healed psoriatic plaque lesions suppresses recurrence better than applying it only on remaining plaques. This finding may be important for instructing psoriatic patients on topical calcipotriol treatment.

Randomized trial of calcipotriol combined with 5-fluorouracil for skin cancer precursor immunotherapy

“…To determine the efficacy of TSLP induction as a cancer immunotherapeutic approach in humans, we focused on the use of topical calcipotriol for the treatment of actinic keratosis. Calcipotriol is a well-tolerated topical medication for psoriasis (19). However, the low concentration of calcipotriol in the clinically available formulation (0.005% ointment) dampened its effect against skin cancer development in mice (Supplemental Figure 2).…”

The signaling involved in autophagy machinery in keratinocytes and therapeutic approaches for skin diseases

“…The vitamin D analogs have been used for the treatment of many skin diseases including psoriasis, recalcitrant warts, lamellar ichthyosis and epidermolytic hyperkeratosis [92-94]. Now recognizing the regulatory mechanism of calcipotriol on autophagy would be helpful to understand the pleiotropic effects of vitamin D analogs and vastly expand the application on the therapy for some skin disease, for example intracellular infection and hyperproliferation.…”

Autoimmunity and autoimmune co‐morbidities in psoriasis

“…The accelerated TNF‐ α /IL‐23/IL‐17 axis coincides with the characteristic histopathology of psoriasis, such as epidermal hyperproliferation, aberrant differentiation and neutrophilic microabscess. Regarding treatments, topical application of steroids and vitamin D3 analogues inhibits psoriatic inflammation and normalizes epidermal differentiation . Systemic treatments, such as cyclosporine, methotrexate and the phosphodiesterase 4 inhibitor apremilast, are useful for patients with extensive lesions .…”

“…Regarding treatments, topical application of steroids and vitamin D3 analogues inhibits psoriatic inflammation and normalizes epidermal differentiation. [61][62][63][64][65] Systemic treatments, such as cyclosporine, methotrexate and the phosphodiesterase 4 inhibitor apremilast, are useful for patients with extensive lesions. [66][67][68] Clinical trials have demonstrated the efficacy of the oral janus kinase inhibitor tofacitinib for psoriasis.…”