Are topical keratolytic agents needed in the treatment of scalp psoriasis?
Dermatol Online J
; 20(3)2014 Mar 17.
Article
em En
| MEDLINE
| ID: mdl-24656276
ABSTRACT
BACKGROUND:
Topical corticosteroids are the primary treatment for scalp psoriasis. Keratolytic agents are promoted as adjunctive treatments. However, complex treatment regimens may result in poor adherence and outcomes.OBJECTIVE:
To evaluate the evidence for the need for use of topical keratolytic agents as opposed to topical corticosteroid monotherapy in the treatment of scalp psoriasis.METHODS:
A review of the literature was performed seeking clinical trials using topical keratolytics, topical corticosteroids or the combination for treatment of scalp psoriasis.RESULTS:
Complete clearance of scalp psoriasis can be achieved in 10-78% of patients using topical corticosteroids alone, in 3% of patients using topical keratolytics alone, and in up to 84% using a combination of topical keratolytics and topical steroids. Clinical trials comparing the combination of keratolytics and topical corticosteroids versus topical corticosteroids alone found marginally more efficacy using combination regimens.LIMITATIONS:
We could not find any long term study evaluating the efficacy of combination therapy in scalp psoriasis and its effect on the patients' adherence.CONCLUSION:
High potency topical corticosteroids are usually effective in treating scalp psoriasis in clinical trials. Poor efficacy in clinical practice may be owing to poor adherence to the treatment regimen. Using a keratolytic agent in conjunction with a topical corticosteroid may provide marginal additional benefit in clinical trials, but that benefit is likely outweighed by the downside of complicating treatment and reducing adherence in the clinical setting, unless a single product containing both medications were used.
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Base de dados:
MEDLINE
Assunto principal:
Psoríase
/
Dermatoses do Couro Cabeludo
/
Ceratolíticos
Limite:
Humans
Idioma:
En
Revista:
Dermatol Online J
Assunto da revista:
DERMATOLOGIA
Ano de publicação:
2014
Tipo de documento:
Article