Topical preparations for the treatment of psoriasis: a systematic review

Abstract

Trials of short duration neither adequately inform the management of chronic disease nor describe the sequelae of treatment. The evidence base for long-term care, reflecting the disease pathway, should be improved. Combination therapy with topical vitamin D analogues and steroids, and maintenance therapy following treatment response merit further investigation.

Binding of all-trans retinoic acid to human serum albumin: Fluorescence, FT-IR and circular dichroism studies

“…It is also well established that retinoic acid helps in the proper development of the central nervous system (CNS) [9,10]. It also directly affects certain leukemias [11], several skin cancers [12] and psoriasis [13]. Thus all-trans RA has great potential to be developed as a pharmaceutical agent.…”

Combination therapy using maxacalcitol and corticosteroid lotions preliminary to monotherapy with maxacalcitol lotion for scalp psoriasis

“…Topical VD 3 generally requires 6 -8 weeks to take maximal effect (17), a fact that serves to explain why switching to VD 3 monotherapy was possible after 4 weeks of the combination therapy. Switching to VD 3 monotherapy produced better results after 8 weeks of the combination therapy, probably because the topical VD 3 produced its maximal effect after 8 weeks.…”

Psoriasis and its management

“…A recent systematic review18 concluded that in the short term active treatment conferred significant benefit over vehicle (around a two point improvement on a 12 point total severity score after six to eight weeks), with no noticeable differences in magnitude of benefit between the different classes of drugs, with the exception of very potent corticosteroids (greatest effect). Comparison of agents in head to head studies indicated that vitamin D analogues were of similar efficacy to potent corticosteroids and more effective than dithranol (fewer reported adverse effects).…”

“…Mild strength corticosteroids or, provided it is for limited periods only, moderate strength corticosteroids can be used for facial and flexural disease. Intermittent use (twice weekly or at weekends)18 or use combined with non-steroidal agents (for example, calcipotriol)18 may maintain remission while minimising risks that can occur with continuous use, such as loss of efficacy, cutaneous atrophy, and rebound or pustular psoriasis. w15 The vitamin D analogues are also widely used, but although efficacy is comparable to that of potent corticosteroids without the attendant risks, onset of action is slow and skin irritation common (about 20%-25% of users), hence the utility of combination therapy with corticosteroids that tends to abrogate both these problems.…”