Psoriasis - Topical Medications

(Page 2)

Highlights	Diagnosis	Managing Psoriasis
Introduction	Treatment	Outlook
Types of Psoriasis	Topical Medications	Resources
Causes	Systemic Medications	References
Risk Factors	Phototherapy

Topical Vitamin D3-Related Treatments

A topical form of vitamin D3, calcipotriene (Dovonex) is proving to be both safe and effective. It is now available in a foam preparation, which makes using it even easier. Several other topical vitamin D3-related drugs that are showing promise include maxacalcitol, tacalcitol, and calcitriol.

Calcipotriene appears to:

Block skin cell reproduction
Enhance the maturity of keratinocytes (the impaired skin cells in psoriasis)
Act as an anti-inflammatory

It works just as well as moderate topical corticosteroids, short-term anthralin, and coal tar in improving mild-to-moderate plaque psoriasis. But unlike with steroids, patients do not develop thinning of the skin or tolerance to the drug.

text continues below

Using the drug in combination with other topical and body-wide treatments may improve its effectiveness. Calcipotriene doesn't work as well as the highest potency corticosteroids, but combining both medications is proving to be more effective than taking either one alone. Taclonex, an ointment containing both calcipotriol and betamethasone, is available for the treatment of adults with psoriasis. Studies show the combination works better than either drug alone.

Combining vitamin D ointments with systemic medicines, notably methotrexate, acitretin, or cyclosporine, increases its effectiveness. Because combining medications allows patients to use lower doses of both medications, combination treatments reduce side effects.

Studies also report success in some patients who use vitamin D ointments in combination with phototherapy treatment.

Side Effects. Calcipotriene may cause the following side effects:

A possible lowering of vitamin D levels, which may affect bone growth in some children
A possible increase in blood calcium levels (seen in some people who apply calcipotriene to large areas)
Skin irritation in about 20% of patients, particularly on the face and in skin folds

Calcipotriene appears to cause greater skin irritation than potent corticosteroids. Diluting the drug with petrolatum or applying topical corticosteroids to sensitive areas may prevent this problem.