Positive effect of using calcipotriol ointment with narrow-band ultraviolet B phototherapy in psoriatic patients.

Abstract

The successful use of narrow-band ultraviolet B (UVB) phototherapy for the management of psoriasis has prompted the examination of various combination treatments with narrow-band UVB. However, there have been contradictory reports on the effect of the calcipotriol-narrow-band UVB combination. This study was performed to compare the clinical efficacy of the calcipotriol-narrow-band UVB combination with narrow-band UVB alone. Of the 28 psoriasis patients, 10 were treated with the calcipotriol-narrow-band UVB and 18 with narrow-band UVB alone. Phototherapy was done once daily three times a week and the dose was gradually increased in a stepwise fashion by 0.05 J/cm2. At the end of therapy, overall efficacy was classified according to the chosen grading system. On assessing the therapeutic results using the criteria selected, 90.0% patients (n = 9) in the calcipotriol-narrow-band UVB group and 61.1% patients (n = 11) in the narrow-band UVB group showed grade IV at the end of therapy. The calcipotriol-narrow-band UVB group showed more rapid improvement at the early stage. The final and total UVB dose were slightly lower in the calcipotriol-narrow-band UVB group but no significant difference was observed with respect to the total number of irradiations, duration of treatment, final UVB dose or total cumulative UVB dose required to reach grade IV in both groups (P > 0.05). The pattern of adverse effects was similar in both groups with a slightly higher frequency in the calcipotriol-narrow-band UVB group. Our results demonstrated that the total cumulative UVB dose required to reach grade IV was not significantly different in both groups, although it was slightly lower in the calcipotriol-narrow-band UVB group. However, a higher percentage of patients attained grade IV at the end of therapy in the combination group and this therapy was more effective in reducing the Psoriasis Area and Severity Index early in treatment. More studies are warranted to confirm these results.