ABSTRACT
Objective To compare clinical efficacy of clobetasol propionate ointment and vitamin A acid cream in the treatment of skin papule type amyloidosis.Methods 100 cases of skin papule type amyloidosis were randomly divided into the observation group and control group,each had 50 patients.The control group was treated with Vitamin A acid cream while the observation group used clobetasol propionate ointment for treatment.Skin lesion area,infiltration,skin color,skin itching score as well as the cure rate and efficiency were compared after 4 weeks of treatment.Results The two groups' symptoms was improved,symptom scores was decreased gradually after treatment than before,the observation group's symptom scores at 1,2,3,4 weeks were (9.35 ± 1.88),(6.54 ±2.16),(4.08 ±1.32),(2.04 ± 0.95) points which was significant better than (10.86 ± 2.08),(7.98 ± 2.57),(6.25 ± 1.44),(4.56 ± 1.18) points of the control group,the difference of two groups was statistically significant (t =6.22,6.71,7.30,7.41,all P ＜ 0.05) ;4 weeks after treatment,the observation group's efficience and cure rates were 94％ and 34％,significantly higher than 70％ and 22％ of the control group,the difference was statistically significant (x2 =9.040,8.391,all P ＜ 0.05).Conclusion Clobetasol propionate ointment has a exact effect in treatment of skinpapule type amyloidosis than vitamin A acid cream,which is worthy of clinical application.
ABSTRACT
BACKGROUND: Narrow-band UVB and topical corticosteroids are treatments for vitiligo. The possible synergistic effect of these modalities has not yet been investigated.OBJECTIVE: This study aims to compare the efficacy of combining narrow-band UVB (NB-UVB) and 0.05% clobetasol propionate ointment (CP) with that of NB-UVB and placebo in inducing initial and overall repigmentation and control of disease activity after 6 months of therapy. Moreover, it aims to assess the safety and determine the permanence ofrepigmentation within I year post-treatment in both regimens.METHODS: Randomized, placebo-controlled, double-blind, left-right comparison was conducted on generalized vitiligo patients with 5-50% body surface area involvement, having at least 2 bilateral, comparative lesions. CP or placebo was applied once daily on either side of the body, each combined with NB-UVB thrice weekly for 6 months.OUTCOME MEASURES: (1) number of exposures and cumulative dose (CD) of NB-UVB that induced initial repigmentation; (2) quantity of repigmentation after 6 months estimated by comparing pre- and post-treatment photographs; (3) effect on disease activity by comparing pre- and post-treatment VIDA (vitiligo disease activity) scores; and (4) permanence of repigmentation and development of new lesions within 1 year post-treatment documented by photographs.ANALYSIS: Sample size was calculated using formula for testing two proportions at 0.05 level of significance and a power of 0.80. Data was analyzed with Student t test (paired), Exact test for symmetry and Wilcoxon signed rank test, depending on the data set involved.RESULTS: Twenty-five patients were recruited, but only 20 were evaluable at the end of the study. Initial repigmentation was noted after a mean of 9.30 +/- 3.54 exposures (mean CD 1,887.8 +/- 1195.81 mJ/cm2) of NB-UVB on the CP-treated side, and after a mean of 15.85 +/- 5.61 exposures (mean CD 4,152.2 +/- 2231.9 mJ/cm2) on the placebo side. After 6 months, 55% (11/20) and 40%(8/20) of patients exhibited marked (>75 %) repigmentation in the NB-UVB with CP side, and NB-UVB with placebo side, respectively. Adverse events were minimal and transient. VIDA scores improved and repigmentation induced by both treatment regimens remained stable in majority within one year post-treatment.CONCLUSIONS: Combination NB-UVB and CP induced repigmentation earlier, requiring significantly lower cumulative dose of NB-UVB than NB-UVB plus placebo. Over all quantity and permanence of repigmentation, as well as control of disease activity and safety, were comparable in the two regimens.