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ΨΩΡΙΑΣΗ - ΝΕΟΤΕΡΑ ΔΕΔΟΜΕΝΑ

ΨΩΡΙΑΣΗ - ΝΕΟΤΕΡΑ ΔΕΔΟΜΕΝΑ

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ΦΕΒΡΟΥΑΡΙΟΣ 2011 - USA- AMERICAN ACADEMY OF DERMATOLOGY.
ΝΕΟ ΘΕΡΑΠΕΥΤΙΚΟ ΣΧΗΜΑ,ΜΕ ΑΠΟΤΕΛΕΣΜΑΤΙΚΟΤΗΤΑ 75%, ΓΙΑ ΤΗ ΨΩΡΙΑΣΗ “ΚΑΤΑ ΠΛΑΚΑΣ”: 1η-2η ΕΒΔΟΜΑΔΑ: ΠΡΩΙ-ΒΡΑΔΥ ΤΟΠΙΚΗ ΕΦΑΡΜΟΓΗ ΙΣΧΥΡΟΥ ΚΟΡΤΙΚΟΣΤΕΡΟΕΙΔΟΥΣ+ΤΟΠΙΚΟΥ ΣΚΕΥΑΣΜΑΤΟΣ ΜΕ ΓΑΛΑΚΤΙΚΟ ΑΜΜΩΝΙΟ 12% ΣΥΝΤΗΡΗΣΗ: KAΘΗΜΕΡΙΝΑ ΠΡΩΙ-ΒΡΑΔΥ ΤΟΠΙΚΟ ΣΚΕΥΑΣΜΑ ΜΕ ΓΑΛΑΚΤΙΚΟ ΑΜΜΩΝΙΟ 12%. ΤΑ ΣΑΒΒΑΤΟΚΥΡΙΑΚΑ ΠΡΩΙ-ΒΡΑΔΥ, ΜΟΝΟ, ΙΣΧΥΡΟ ΤΟΠΙΚΟ ΚΟΡΤΙΚΟΣΤΕΡΟΕΙΔΕΣ.
ΦΕΒΡΟΥΑΡΙΟΣ 2011 - USA- AMERICAN ACADEMY OF DERMATOLOGY.
ΝΕΟ ΘΕΡΑΠΕΥΤΙΚΟ ΣΧΗΜΑ,ΜΕ ΑΠΟΤΕΛΕΣΜΑΤΙΚΟΤΗΤΑ 75%, ΓΙΑ ΤΗ ΨΩΡΙΑΣΗ “ΚΑΤΑ ΠΛΑΚΑΣ”: 1η-2η ΕΒΔΟΜΑΔΑ: ΠΡΩΙ-ΒΡΑΔΥ ΤΟΠΙΚΗ ΕΦΑΡΜΟΓΗ ΙΣΧΥΡΟΥ ΚΟΡΤΙΚΟΣΤΕΡΟΕΙΔΟΥΣ+ΤΟΠΙΚΟΥ ΣΚΕΥΑΣΜΑΤΟΣ ΜΕ ΓΑΛΑΚΤΙΚΟ ΑΜΜΩΝΙΟ 12% ΣΥΝΤΗΡΗΣΗ: KAΘΗΜΕΡΙΝΑ ΠΡΩΙ-ΒΡΑΔΥ ΤΟΠΙΚΟ ΣΚΕΥΑΣΜΑ ΜΕ ΓΑΛΑΚΤΙΚΟ ΑΜΜΩΝΙΟ 12%. ΤΑ ΣΑΒΒΑΤΟΚΥΡΙΑΚΑ ΠΡΩΙ-ΒΡΑΔΥ, ΜΟΝΟ, ΙΣΧΥΡΟ ΤΟΠΙΚΟ ΚΟΡΤΙΚΟΣΤΕΡΟΕΙΔΕΣ.

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Published by: Κνησμός Φαγουρα on Jul 11, 2012
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Η ΠΑΡΑΚΑΣΧ ΙΑΣΡΙΚΗ ΚΛΙΝΙΚΗ ΜΔΛΔΣΗ (ΙΔΞΗΥΘΗ ΢ΣΙ΢ ΗΠΑ)ΠΡΟΣΔΙΝΔΙ
 
ΓΙΑ ΣΗ ΧΡΙΑ΢Η “ΚΑΣΑ ΠΛΑΚΑ΢”
,
ΔΝΑ ΝΔΟΘΔΡΑΠΔΤΣΙΚΟ ΢ΥΗΜΑ,
 
ΜΔΑΠΟΣΔΛΔ΢ΜΑΣΙΚΟΣΗΣΑ 75%
:
ΘΔΡΑΠΔΙΑ:
 
-
2η ΔΒΟΜΑΑ
: ΠΡΩΙ
-
ΒΡΑΤ ΣΟΠΙΚΗ ΔΦΑΡΜΟΓΗ Ι΢ΥΤΡΟΤ
 
ΚΟΡΣΙΚΟ΢ΣΔΡΟΔΙΟΤ΢+ΣΟΠΙΚΟΤ ΢ΚΔΤΑ΢ΜΑΣΟ΢ ΜΔ ΓΑΛΑΚΣΙΚΟ
 
ΑΜΜΩΝΙΟ 12%
 
΢ΤΝΣΗΡΗ΢Η:
( ΑΠΟ ΣΗΝ 3
η
 
ΔΒΟΜΑΑ ΚΑΙ ΜΔΣΑ )
 
KAΘΗΜΔΡΙΝΑ
 
(ΔΤΣΔΡΑ ΔΩ΢ ΚΑΙ ΠΑΡΑ΢ΚΔΤΗ)
:
ΠΡΩΙ
-
ΒΡΑΤ
,MONO,
ΣΟΠΙΚΟ ΢ΚΔΤΑ΢ΜΑ ΜΔ
 
ΓΑΛΑΚΣΙΚΟ ΑΜΜΩΝΙΟ 12%.
ΣΑ ΢ΑΒΒΑΣΟΚΤΡΙΑΚΑ
:
ΠΡΩΙ
-
ΒΡΑΤ,ΜΟΝΟ, Ι΢ΥΤΡΟ ΣΟΠΙΚΟΚΟΡΣΙΚΟ΢ΣΔΡΟΔΙΔ΢.
 
 
΢ΣΗΝ ΔΛΛΑΑ ΜΟΝΟ Η RAXAL cream ΚΑΙ Η
LACUREX ointment
ΠΔΡΙΔΥΟΤΝ
AMMONIUM LACTATE 12% !!!!
 
ΤΠΔΡΗΦΑΝΑ
 
ΔΛΛΗΝΙΚ
A
ΠΡΟ
'
Ι
'
ΟΝ
TA !
ΔΛΛΗΝΙΚΟ΢
 
΢ΥΔΙΑ΢ΜΟ΢
 
ΚΑΙ
 
ΠΑΡΑΓΧΓΗ
!
Original ResearchA Randomized, Double-blind, Placebo-controlled Study toEvaluate the Safety and Efficacy of Ammonium Lactate Lotion12% and Halobetasol Propionate Ointment 0.05% in theTreatment and Maintenance of Psoriasis
February 2011
 
Jason J. Emer, MD; Amylynne Frankel, MD; Andrew Sohn, BS; Mark Lebwohl, MDMount Sinai Schoolof Medicine, Department of Dermatology, New York, New York
Disclosure:Dr. Emer, Dr. Frankel, and Mr. Sohn report no relevant conflicts of interest. Dr. Lebwohl lectures for Ranbaxy. Funding sources for this study were provided by Ranbaxy Laboratories, Inc. Thedata for this clinical trial have been presented in poster format at the Winter Clinical Dermatology Conference, Grand Hyatt Kauai, Hawaii; January 23
28, 2010, and the Fall Clinical Dermatology Conference, Wynn Hotel, Las Vegas, Nevada; October 16
19, 2010.
 
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Abstract
Consensus recommends a gradual reduction in the frequency or steroid potencyof topical corticosteroids following clinical improvement in the treatment of psoriasis, although no established guidelines have been developed. The authorssought to evaluate a combination regimen in the treatment and maintenance of psoriasis. Patients with mild-to-moderate psoriasis were enrolled (n=55) in arandomized, double-blind, placebo-controlled study using ammonium lactatelotion and halobetasol ointment. Those with initial improvement of target plaquesafter two weeks of combination treatment twice daily were randomized to amaintenance phase (n=41). Patients applied ammonium lactate lotion twice dailyevery day and either placebo ointment (n=20) or steroid ointment (n=21) twicedaily on weekends only. Forty-
one of 55 patients(74.6%) were rated as “clear”(0)or “almost clear” (1) after two weeks of combinatio
n treatment. In themaintenance phase, the probability of physician global assessment worsening atsix weeks in the steroid group was only 10 percent while in the placebo group theprobability rose to 75 percent (p<0.0001). The probability of physician globalassessment worsening climbed to 100 percent by 14 weeks in the placebo groupwhile only increasing to 29 percent in the steroid group (p<0.0001).Twelvepatients at study termination still had not worsened. Worsening of the physicianglobal assessment index was more likely (HR 7.8 [2.84, 21.43]) in the placebogroup than in the steroid group (p<0.0001). No cutaneous side effects, such assteroid atrophy or irritation, were noted.
Combination treatment effectivelycleared plaque psoriasis initially
, and
ammonium lactate twice daily everyday with weekend-only applications of halobetasol ointment effectivelysustained the initial improvement for a significantly longer period of time
when compared with placebo without demonstrating any significant side effects,such as steroid atrophy.
 
(J Clin Aesthet Dermatol . 2011;4(2):28
39.)
 
 
Conclusion
 
Combination twice-daily ammonium lactate lotion and halobetasolointment for two weekseffectively cleared plaque psoriasis inapproximately 75 percent of patients.
 Halobetasol ointment weekend-only maintenance therapy in combination withtwice-daily ammonium lactate lotion effectively sustained initial improvement fora significantly longer period of time when compared with placebo.
No adverse effects
, such as cutaneous irritation, atrophy, or telangiectasia,were noted through the study.Although topical corticosteroids are an integral part of the therapeutic treatmentoptions for the treatment of psoriasis and extremely safe when used judiciously inthe short term, long-term maintenance regimens incorporating dose or frequencyreduction or the addition of a second corticosteroid-sparing agent is the mostoptimal for successful remissions. Future studies incorporating combination or
 
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rotational therapies in the long term will determine guidelines for mostadvantageous remissions and maintenance thereof.
References
1. van de Kerkhof PC, Franssen ME. Psoriasis of the scalp. Diagnosis and management. Am J ClinDermatol.2001;2: 159
165.2. Sigmundsdottir H. Improving topical treatments for skin diseases. Trends Pharmacol Sci.2010;31:239
245.3. Sukarovska BG, Lipozenciç J, Vrzogiç P. [Topical cortico-steroids and corticosteroid sparing therapyin psoriasismanagement]. Acta Med Croatica. 2007;61: 375
381.4. Gold LF. Calcitriol ointment: optimizing psoriasis therapy. J Drugs Dermatol. 2009;8:s23
s27.5. Kamili QU, Menter A. Topical treatment of psoriasis. Curr Probl Dermatol. 2009;38:37
58.6. Bailey J, Whitehair B. Topical treatments for chronic plaque psoriasis. Am Fam Physician.2010;81:596.7. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis andpsoriaticarthritis. Section 3. Guidelines of care for the management and treatment of psoriasis withtopical therapies. J AmAcad Dermatol. 2009;60:643
659.8. Lavker RM, Kaidbey K, Leyden JJ. Effects of topical ammonium lactate on cutaneous atrophy from apotenttopical corticosteroid. J Am Acad Dermatol. 1992;26:535
544.9. Gribetz C, Ling M, Lebwohl M, et al. Pimecrolimus cream 1% in the treatment of intertriginouspsoriasis: adouble-blind, randomized study. J Am Acad Dermatol. 2004;51:731
738.10. Lebwohl M, Freeman AK, Chapman MS, et al. Tacrolimus Ointment Study Group. Tacrolimusointment iseffective for facial and intertriginous psoriasis. J Am Acad Dermatol. 2004;51:723
730.11. Freeman AK, Linowski GJ, Brady C, et al. Tacrolimus ointment for the treatment of psoriasis onthe face andintertriginous areas. J Am Acad Dermatol. 2003;48:564
568.12. Bernhard J, Whitmore C, Guzzo C, et al. Evaluation of halobetasol propionate ointment in thetreatment of plaque psoriasis: report on two double-blind, vehicle-controlled studies. J Am AcadDermatol. 1991;25:1170
1174.13. Lebwohl M, Sherer D, Washenik K, et al. A randomized, double-blind, placebo-controlled study of clobetasolpropionate 0.05% foam in the treatment of nonscalp psoriasis. Int J Dermatol.2002;41:269
274.14. Gottlieb AB, Ford RO, Spellman MC. The efficacy and tolerability of clobetasol propionate foam0.05% in thetreatment of mild to moderate plaque-type psoriasis of nonscalp regions. J Cutan MedSurg. 2003;7:185
192.15. Olsen EA, Cram DL, Ellis CN, et al. A double-blind, vehicle-controlled study of clobetasolpropionate 0.05%(Temovate) scalp application in the treatment of moderate to severe scalp psoriasis.J Am Acad Dermatol.1991;24:443
447.
16. Lebwohl M. A clinician’s paradigm in the treatment of psoriasis. J Am Acad Dermatol.
2005;53:S59
S69.17. Lebwohl M, Kathryn M. New roles for systemic retinoids. J Drugs Dermatol. 2006;5:406
409.18. Koo JY. New developments in topical sequential therapy for psoriasis. Skin Therapy Lett.2005;10:1
4.

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