Scalp Psoriasis Research Articles

Treatment effect of adalimumab and infliximab in Japanese psoriasis patients: Results in a single community‐based hospital

Because adalimumab and infliximab were approved in Japan for psoriasis treatment only 1 year ago, therapeutic efficacy of these agents is not well studied in a Japanese psoriasis population. Moreover, the evaluation of scalp psoriasis treated with biologics has never been reported in these subjects. In this study, 21 patients with moderate to severe plaque psoriasis were assigned to receive adalimumab 40 mg every other week with an initial loading dose of 80 mg (n = 11), or infliximab 5 mg/kg at weeks 0, 2, 6, 14 and 22 (n = 10). The treatment efficacy was evaluated by the proportion of patients who achieved at least 75% improvement in Psoriasis Area and Severity Index (PASI 75) and Psoriasis Scalp Severity Index score (PSSI 75) from baseline at weeks 4, 8, 16 and 24. A patient selection bias existed between the two groups in body surface area and PASI (44.0 ± 24.7 vs 30.2 ± 13.5, P = 0.12 and 22.2 ± 9.3 vs 15.6 ± 7.75, P = 0.09, respectively). At week 16, 81.8% of adalimumab-treated patients and 60.0% of infliximab-treated patients achieved PASI 75 response, but no statistically significant difference was found between these response rates. There was a tendency toward a reduced PSSI 75 response rate in the adalimumab-treated group compared to the infliximab-treated group (54.5% vs 90% at week 16, P =0.15). In conclusion, both of the tumor necrosis factor-α inhibitors demonstrated good therapeutic response similar to that in the previously reported randomized controlled trials, without any severe adverse reactions. Treatment response in scalp lesions tended to be lower in adalimumab-treated patients, possibly because of delayed treatment onset of adalimumab.

Rapid response of scalp psoriasis to ustekinumab

ejd.2011.1499 Auteur(s) : Antonella Di Cesare, Maria Concetta Fargnoli, Ketty Peris ketty.peris@univaq.it Department of Dermatology,University of L’Aquila,Via Vetoio Coppito 2, 67100 L’Aquila, Italy Involvement of the scalp is a common manifestation of psoriasis, occurring in up to 80% of patients. Lesions present as erythematous, scaly and frequently itching plaques, involving small areas up to the whole scalp [1, 2]. Due to the high visibility of the lesions, scalp psoriasis is often [...]

Cost‐effectiveness evaluation of clobetasol propionate shampoo (CPS) maintenance in patients with moderate scalp psoriasis: a Pan‐European analysis

Scalp psoriasis is a difficult to treat and usually chronic manifestation of psoriasis. The CalePso study showed that CPS (Clobex(®) Shampoo) in maintenance therapy of scalp psoriasis (twice weekly) significantly increases the probability of keeping patient under remission during 6 months, compared with vehicle (40.3% relapses vs. 11.6% relapses, ITT). The objective of the study was to assess the cost-effectiveness of a maintenance therapy with CPS vs. its vehicle in nine European countries. A 24-week decision tree model was developed with 4-weekly time steps. The considered population has moderate scalp psoriasis successfully treated with a daily application of CPS up to 4 weeks. Data were taken from the CalePso study and from national experts' recommendations for alternative treatment choices, with their probabilities of success taken from literature to develop country-specific models. Health benefits are measured in disease-free days (DFD). The economic analysis includes drug and physician costs. A probabilistic sensitivity analysis (PrSA) assesses the uncertainty of the model. Depending on the country, the mean total number of DFDs per patient is 21-42% higher with CPS compared with vehicle, and the mean total cost is 11-31% lower. The mean costs per DFD are 30-46% lower with CPS compared with the vehicle. The PrSA showed in 1000 simulations that CPS is more effective vs. vehicle in 100% of the cases and less expensive than its vehicle in 80-99% of the cases. This model suggests that CPS is cost-effective in maintaining the success achieved in moderate scalp psoriasis patients.

Psoriasis and palmoplantar pustulosis associated with tumor necrosis factor-α inhibitors: The Mayo Clinic experience, 1998 to 2010

Tumor necrosis factor (TNF)-α antagonists have been associated with the induction of de novo or worsening psoriasis. We sought to retrospectively examine the clinical characteristics and outcomes of patients with psoriasis associated with anti-TNF-α therapy. We performed a retrospective review of patients with new-onset or worsening psoriasis during TNF-α inhibitor therapy between 1998 and 2010. Of the 56 patients (mean age at psoriasis onset, 48.1 years), 41 (73%) were female. In all, 22 patients (39%) had Crohn's disease and 14 (25%) had rheumatoid arthritis. Thirty patients (54%) were treated with infliximab, 19 (34%) with adalimumab, and 7 (12%) with etanercept. New-onset or worsening psoriasis occurred after a mean treatment duration of 17.1 months. Plaque psoriasis (n = 27), palmoplantar pustulosis (n = 25), scalp psoriasis (n = 12), generalized pustular psoriasis (n = 7), erythrodermic psoriasis (n = 2), and inverse psoriasis (n = 2) were the cutaneous presentations. Among the 39 patients for whom full treatment response data were available, 33 (85%) had a complete or partial response; combined response rates (complete and partial) were slightly higher among those who discontinued anti-TNF-α therapy (16 of 17 patients [94%]) than among those who continued anti-TNF-α therapy (17 of 22 patients [77%]). Retrospective nature, possible referral bias, and lack of complete follow-up for some patients are limitations. Although some patients sufficiently controlled their psoriasis while continuing anti-TNF-α therapy, those who discontinued therapy achieved higher rates of complete response. Further studies should explore the efficacy and safety of switching to an alternative anti-TNF-α agent.

Videodermoscopy Scalp Psoriasis Severity Index (VSCAPSI): A useful tool for evaluation of scalp psoriasis

The standard methods used to diagnose scalp psoriasis vary in sensitivity, reproducibility, and invasiveness. Videodermoscopy can be used to explore microcirculatory modifications in skin diseases. Psoriasis presents three pathognomonic vascular patterns: red dots, hairpin vessels and red globular rings. Our aim was to create a videodermoscopy scalp psoriasis severity index (VSCAPSI) for evaluation of scalp psoriasis, especially mild and moderate forms that often are not clinically appreciable. VSCAPSI takes into account the area of the scalp affected by psoriasis, the presence and morphology of vascular patterns, the erythema and desquamation. Videodermoscopy images obtained between November 2009 to June 2010 from 900 participants with various scalp and hair disorders were reviewed for distinguishing features. During the 2010 Italian congress on psoriasis, in order to assess the reproducibility and efficacy of the VSCAPSI, 146 dermatologists were asked to evaluate 16 videodermoscopy images of scalp psoriasis using the VSCAPSI. Of the 900 patients, 85 new cases of scalp psoriasis were diagnosed. The other 815 patients were found to be suffering from different scalp and hair diseases. Of 146 dermatologists, 28 did not recognize erythema, 15 desquamation and 7 the vascular patterns. The VSCAPSI provides important evidence for early diagnosis, differential diagnosis, for follow-up and screening.

Etanercept Performs Well for Scalp Psoriasis

Etanercept Performs Well for Scalp Psoriasis

Novel stain‐free lecithinized coal tar formulation for psoriasis

Coal tar has been a very popular traditional treatment for various types of psoriasis for over a century. It is the first-line treatment for scalp, hand, and foot psoriasis. However, the application of coal tar on hair invariably causes staining, which results in a high degree of patient non-compliance, especially in patients with non-black hair. Thus, the treatment of scalp psoriasis with a topical coal tar formulation requires that special concern be paid to product esthetics. This study aimed to evaluate the hair-staining characteristics of a novel lecithinized coal tar (LCT) formulation on different types of mammalian hair. Samples of hair from different mammals, including human, sheep, rabbit, and goat, were repeatedly exposed to the LCT formulation over 14 days. The color of hair samples treated with LCT was compared with that of untreated control hair samples. The study revealed the distinct non-staining potential of the LCT formulation. This LCT formulation lacks the propensity to stain hair and thus has excellent potential to be exploited in the treatment of scalp psoriasis.

Childhood psoriasis: Analytic retrospective study in Saudi patients

Psoriasis is a genetically determined chronic inflammatory and immunologically mediated disease. At an early age, the presentation of psoriasis may be atypical. Among all types of childhood psoriasis, plaque type is the most common. In this article, we report our data analysis on the main clinical aspects of childhood psoriasis, its onset, risk factors, demographics and therapeutic options. A total of 36 patients with childhood psoriasis were evaluated at the dermatology out-patient clinic in the college of medicine at King Saud University during the period from April 2002 to June 2007. All patients were diagnosed based on clinical findings. Of the 36 patients, 24 (66.67%) had generalized plaque type psoriasis, 8 (22.2%) had guttate psoriasis, 4 (11.1%) had mixed plaque type and guttate psoriasis, 6 (16.67%) had localized plaque type (on elbows and knees), 4 (11.11%) had palmoplanter psoriasis and 1 (2.77%) had scalp psoriasis. Among those, one patient had congenital psoriasis. The age of patients ranged from 8 months to 18 years (mean = 11.3 years). There were 15 males and 21 females. The mean duration of the disease was 3.04 years and family history was positive in 10 patients (27.78%). All patients were treated by topical medications and/or narrow-band ultraviolet-B phototherapy. Apart from prolonged tanning no significant adverse effects were reported. Of particular interest, skin cancer was not detected in this series of children even after repeated courses. In conclusion, childhood psoriasis is more common in girls with plaque type psoriasis being the most common type. Topical therapy is the mainstay treatment for localized disease and narrow-band ultraviolet-B phototherapy is considered safe and effective for moderately severe conditions. More studies are required to define the safety of systemic therapy and biologic treatment in this age group of psoriasis.

Effective treatment and improvement of quality of life in patients with scalp psoriasis by topical use of calcipotriol/betamethasone (Xamiol®‐gel): results

Quality of life of patients with scalp psoriasis is greatly impaired due to itch and scaling. To control the disease long-term therapy is necessary and treatment success is greatly dependent on compliance. In a prospective, non-interventional trial in German dermatological practices 721 patients with scalp psoriasis received Xamiol(®) gel (calcipotriol 50 μg/g, betamethasone 0,5 mg/g) topically for 4 weeks. Severity was assessed by physician's global assessment (PGA) and quality of life by using a scalp-specific questionnaire at the beginning of the study and after 4 weeks of treatment. The mean disease severity of scalp psoriasis (PGA) improved from 4.26 to 2.49 (-41.8 %, p < 0.0001) during 4 weeks of treatment and quality of life improved from 10.57 to 3.22 (-69.5 %, p < 0.0001). Among patients with pre-treatment 89.5 % of patients and 87.9 % of dermatologists judged treatment response to Xamiol(®) gel as better/much better compared to previous therapy. Tolerability of Xamiol(®) gel was rated good/very good by 98 % of dermatologists and patients, respectively. The use of Xamiol(®) gel was found easy/very easy by 90.4 % of the patients. Due to the major improvement of quality of life and quick onset of improvement together with the high acceptance by the patients Xamiol(®) gel may be regarded as the topical treatment of choice for scalp psoriasis.

Calcipotriol/Betamethasone Dipropionate

Calcipotriol/betamethasone dipropionate (calcipotriol 50 μg/g and betamethasone 0.5 mg/g) is a fixed-dose combination of a vitamin D(3) analogue and a corticosteroid indicated for the once-daily, topical treatment of psoriasis vulgaris of the trunk, limbs and scalp in adults. Both the ointment (Daivobet®; Dovobet®) and gel (Xamiol®; Daivobet® Gel; Dovobet® Gel) formulations of calcipotriol/betamethasone dipropionate can be used to treat psoriasis vulgaris of the trunk and/or limbs, although the gel formulation was specifically developed for the treatment of scalp psoriasis. This article reviews the efficacy and tolerability of calcipotriol/betamethasone dipropionate in patients with psoriasis vulgaris, as well as summarizing its pharmacological properties. Calcipotriol/betamethasone dipropionate has low systemic absorption and displays local anti-inflammatory and immunoregulatory properties. It reduces the hyperproliferation of keratinocytes and helps normalize keratinocyte differentiation. In large, well designed clinical trials, calcipotriol/betamethasone dipropionate, either as the ointment or the gel formulation, applied once daily for 4-8 weeks, was more effective than placebo, calcipotriol and tacalcitol, as well as betamethasone dipropionate in most instances, for the topical, symptomatic treatment of psoriasis vulgaris of the trunk/limbs. Likewise, calcipotriol/betamethasone dipropionate gel applied once daily for 8 weeks was more effective than placebo or either component alone in the topical, symptomatic treatment of psoriasis vulgaris of the scalp. Long-term, once-daily, when required therapy with calcipotriol/betamethasone dipropionate for 52 weeks was more effective than calcipotriol alone for the treatment of scalp psoriasis, and was at least as effective as switching to calcipotriol for 48 weeks after 4 weeks of calcipotriol/betamethasone dipropionate or alternating between calcipotriol/betamethasone dipropionate and calcipotriol every 4 weeks for 52 weeks in the treatment of psoriasis vulgaris of the trunk/limbs. Calcipotriol/betamethasone dipropionate also improved health-related quality of life. Calcipotriol/betamethasone dipropionate was generally well tolerated, with most adverse drug reactions being lesional or perilesional effects of mild or moderate severity. Calcipotriol/betamethasone dipropionate was often associated with fewer lesional/perilesional adverse reactions than calcipotriol or tacalcitol and did not appear to be associated with a higher incidence of corticosteroid-related adverse events during long-term therapy. Pharmacoeconomic analyses predicted calcipotriol/betamethasone dipropionate to be more cost effective than other topical therapies. Thus, calcipotriol/betamethasone dipropionate is an important, effective, once-daily, topical therapy for the symptomatic treatment of psoriasis vulgaris of the trunk, limbs and scalp.

Dermoscopy can be useful in differentiating scalp psoriasis from seborrhoeic dermatitis

Psoriasis and seborrhoeic dermatitis are common erythematous-squamous dermatoses that may present with scaly erythematous patches on the scalp. Owing to the similar clinicopathological features of these dermatoses, their differentiation poses a diagnostic challenge, particularly when the lesions on the scalp are isolated. To evaluate the usefulness of dermoscopy in the clinical differentiation of scalp psoriasis and seborrhoeic dermatitis. This was a retrospective observational study to evaluate the characteristic dermoscopic features of scalp psoriasis and seborrhoeic dermatitis. The study included a total of 96 patients with lesions; these patients were recruited from two tertiary teaching hospitals in Korea (Pusan National University Hospital and Kyungpook National University Hospital). Among these, 55 patients had scalp psoriasis and 41 patients had seborrhoeic dermatitis. The most significant dermoscopic features of scalp psoriasis were red dots and globules, twisted red loops, and glomerular vessels. In contrast, seborrhoeic dermatitis was characterized by arborizing vessels and atypical red vessels with the absence of red dots and globules. Featureless areas devoid of any particular vascular patterns were also frequently observed in seborrhoeic dermatitis. Dermoscopic findings of red lines and other vascular patterns were not considered useful for differentiation because these were uncommon features in both diseases. Although scales were observed commonly in both diseases, there was no significant difference in the frequency and characteristics of the scales when they were observed using dermoscopy. Our study shows that the investigation of vascular patterns by using dermoscopy can be valuable for the clinical diagnosis and differentiation of scalp psoriasis and seborrhoeic dermatitis.

Dermoscopy can be useful in differentiating scalp psoriasis from seborrheic dermatitis

Dermoscopy can be useful in differentiating scalp psoriasis from seborrheic dermatitis

Treatment of scalp psoriasis with clobetasol-17 propionate 0.05% shampoo: a study on daily clinical practice

Treatment of scalp psoriasis with clobetasol-17 propionate 0.05% shampoo: a study on daily clinical practice

Heterogeneity in the treatment of moderately severe scalp psoriasis in Scotland – results of a survey of Scottish health professionals

Background:Scalp psoriasis is a chronic recalcitrant condition. An aging literature for topical treatments used in clinical practice and no treatment guidelines means there is no current gold standard for its management in Scotland. There are no Scottish data on the resources and costs of treatment of the scalp psoriasis patient.Objective:Conduct a survey of Scottish healthcare professionals to understand how patients are typically managed to support the development of a model estimating the cost-effectiveness of a new treatment for moderately severe scalp psoriasis in Scotland.Research design and methods:Experts from primary and secondary care were invited to participate in an interview programme to collect information on the management of scalp psoriasis in Scotland. This was further informed by Scottish prescribing statistics. Simple descriptive statistics were performed.Results:Forty-three healthcare professionals (33 from primary care and ten in secondary care) completed the survey which illuminated national prescribing statistics. While an overall 72% response rate was achieved, representation from five of 14 Health Boards was not available. There was significant variation in stated patient pathways but some common themes. Most patients were treated initially with coal tar preparations and shampoos, then often progressing to topical potent corticosteroids. There was no consensus on the order patients might receive topicals thereafter although if referred for specialist review they would typically have been treated with three topicals in primary care first. Treatment in secondary care comprised application of topicals available in primary care or alternative preparations with nurse assistance to improve compliance. Phototherapy and systemic agents were not given to patients with scalp psoriasis alone. Study limitations are not considered to impact on the study observations.Conclusions:There was a large variety in first-, second- and third-line agents in primary care in scalp psoriasis although our interview programme and prescribing data confirmed which treatments were most frequently prescribed. Treatment heterogeneity reflects the limitations in current therapies, paucity of evidence-based effectiveness data and lack of clinical guidelines. Experts agreed ‘current standard practice’ in Scotland was best described as an average across five plausible treatment pathways.

Significant one week efficacy of a calcipotriol plus betamethasone dipropionate scalp formulation

A two-compound scalp formulation containing calcipotriol (50 μg/g) and betamethasone (0.5mg/g; as dipropionate) (Xamiol, Taclonex Scalp) has been shown to be an effective and safe treatment for scalp psoriasis. The aim of this study was to investigate the clinical efficacy of the two-compound scalp formulation after 1 week of treatment. methods: Pooled data from two large pivotal phase III trials with 2920 patients receiving once-daily treatment for up to 8 weeks with either the two-compound scalp formulation (n = 1108), betamethasone dipropionate (n = 1118), calcipotriol (n = 558), or the vehicle (n = 136) were analysed. The percentage of patients who had 'absent' or 'very mild' disease according to Investigator's Global Assessment after 1 week of treatment was significantly higher with the two-compound scalp formulation (30.6%) compared to betamethasone (24.1%; P < 0.001), calcipotriol (10.0%; P < 0.001) or vehicle (6.9%; P < 0.001). This data indicates that the two-compound scalp formulation demonstrated significant efficacy already after 1 week, with a faster onset of effect than either of the individual components in the same vehicle, in the treatment of scalp psoriasis.

Scalp Psoriasis: A Review of the Current Therapies and Case Report of the Successful Use of the Excimer Laser in Recalcitrant Disease

Psoriasis vulgaris is an extremely common immune-mediated inflammatory disease that affects about 0.6% to 4.8% of the general population worldwide. As reported by several surveys, the most common anatomic location affected by psoriasis is the scalp. The clinical presentation varies from mild to severe and typically presents with asymmetric, sharply demarcated, silvery white erythematous scaly plaques that are often pruritic. Additionally, serious psychosocial consequences are often experienced by patients with scalp psoriasis. Despite the fact that scalp disease is so frequent and debilitating, it remains particularly difficult to treat because of the lack of patient compliance and a paucity of evidence-based data to help guide treatment. In 2009, however, the medical board of the National Psoriasis Foundation created an algorithm to facilitate the treatment of scalp psoriasis. In this case review, we describe a scenario in which this algorithm was used successfully. Our patient suffered from psoriasis limited to the scalp for almost 14 years. After several first- and second-line therapies failed, this patient was treated successfully 4 years ago and currently remains in remission after therapy with the ultraviolet B narrowband (308 nm) excimer laser. Therefore, for patients with recalcitrant plaques limited to the scalp, the excimer laser should be considered as a third-line therapy.

A calcipotriene/betamethasone dipropionate two‐compound scalp formulation in the treatment of scalp psoriasis in Hispanic/Latino and Black/African American patients: results of the randomized, 8‐week, double‐blind phase of a clinical trial

The calcipotriene/betamethasone dipropionate two-compound scalp formulation has been shown to be safe and effective in the treatment of scalp psoriasis over 8 weeks, but the patients studied were mainly White and non-Hispanic. The aim of this study was to evaluate the efficacy and safety of the two-compound scalp formulation in the treatment of scalp psoriasis in Hispanic/Latino and Black/African American patients. A total of 99 Hispanic/Latino and 78 Black/African American patients were randomized double-blind in a 3:1 ratio to 8 weeks of once daily treatment of scalp psoriasis with either the two-compound scalp formulation (n=135) or its vehicle (n=42). In the two-compound group, 71.9% of patients had cleared or minimal disease at week 8 by the investigator's global assessment compared to 40.5% in the vehicle group (odds ratio 3.30; 95% CI 1.62-6.72; P<0.001). For the five secondary efficacy response criteria, three (total sign score, thickness of scalp psoriasis, patient's global assessment) showed that two-compound scalp formulation was statistically significantly more effective than its vehicle, and the other two (redness and scaliness of scalp psoriasis) approached statistical significance in favor of the two-compound scalp formulation. There was no statistically significant difference (P=1.00) between the percentage of patients with adverse reactions in the two-compound group (7.0%) and the vehicle group (7.9%). The two-compound scalp formulation is safe and effective in the treatment of scalp psoriasis over 8 weeks in Hispanic/Latino and Black/African American patients.

Tratamiento de la psoriasis del cuero cabelludo. Revisión de la evidencia y Consenso Delphi del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología

Scalp lesions are common in psoriasis and difficult to treat. Scientific evidence on the topic is scant and fragmentary, especially with respect to long-term treatment. This consensus statement is based on a critical assessment of the results of a MEDLINE search for clinical trials of the efficacy and safety of therapies used to treat scalp psoriasis. The recommendations were developed by an expert panel using the Delphi process to reach a consensus and then ratified by the members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. The recommended induction therapy for scalp psoriasis is either a topical corticosteroid or a topical treatment combining calcipotriol and betamethasone. The choice of an appropriate vehicle is crucial in improving effectiveness and patient adherence to treatment. The only formulations that have been studied in the long-term treatment of scalp psoriasis are a combination of calcipotriol and betamethasone in gel and calcipotriol alone in solution.

Gene expression profiling in psoriatic scalp hair follicles: clobetasol propionate shampoo 0.05% normalizes psoriasis disease markers

Clobetasol propionate shampoo is effective and safe in treatment of scalp psoriasis (SP). Gene expression profiling of psoriatic skin biopsies led to the identification of numerous disease-related genes. However, it remained unknown whether the gene expression profile of hair follicles of SP patients was also affected. To determine whether psoriasis-related genes are differentially regulated in the hair follicles of SP patients and whether the modulation of these genes can be correlated with clinical severity scores. A single arm, open study was conducted in three centres. SP patients received daily treatment with clobetasol propionate shampoo. At Baseline, Weeks 2 and 4, investigators assessed clinical severity parameters and collected scalp hair follicles in anagen phase. Total RNA extracted from hair follicles was used to determine the expression level of 44 genes, which were reported previously to be upregulated in the skin of psoriasis patients. RNA of good quality and sufficient quantity was obtained from hair follicles of psoriasis patients and healthy volunteers (HV). The expression level of 10 inflammation-related genes was significantly increased in psoriatic hair follicles. The patient's exploratory transcriptomic score, defined as the mean fold modulation of these 10 genes compared with HV, correlated with clinical severity scores. Clobetasol propionate shampoo was effective in decreasing both the exploratory transcriptomics and the clinical severity scores. Hair follicles of SP patients are affected by the inflammatory process. The change in the expression level of inflammation-related genes correlates with the severity of the disease.

Treatment of scalp psoriasis with clobetasol‐17 propionate 0.05% shampoo: a study on daily clinical practice

Safety and clinical effectiveness of clobetasol-17 propionate 0.05% shampoo have been shown in patients with scalp psoriasis. First, to evaluate treatment satisfaction, user convenience safety and effectiveness of clobetasol-17 propionate 0.05% shampoo treatment in daily clinical practice. Second, to identify subgroup variables that may predict treatment success or failure. A total of 56 patients with scalp psoriasis were treated with short-contact clobetasol-17 propionate 0.05% shampoo once daily for 4 weeks. Data on treatment satisfaction, user convenience, safety and effectiveness were assessed on a 7-point Likert scale using postal questionnaires. Subgroup analyses were performed to identify variables that may predict treatment outcome. A total of 41 patients returned both questionnaires (73%). Positive treatment satisfaction and user convenience were reported by 66% and 79% of patients respectively. Patient-rated indicators for disease severity improved by 39-46% (P < 0.05%). No major side-effects were reported. Subgroup analyses did not reveal any statistically significant patient variable that may predict treatment outcome. However, a tendency towards improved treatment satisfaction was observed in patients who had received fewer topical antipsoriatic treatments previously (P > 0.05). Short-contact treatment with clobetasol-17 propionate 0.05% shampoo has high user convenience and patient satisfaction rates. Moreover, the treatment is well-tolerated and efficacious from patients' perspective. Subgroup analyses did not reveal factors predicting treatment outcome, although treatment success tended to be more evident in patients who had received fewer treatments previously.