Comparison of topical clobetasol propionate 0.05% and topical tacrolimus 0.1% in the treatment of cutaneous lichen planus

The Management of Plaque Psoriasis With Halobetasol and Tacrolimus Combination Therapy Versus Calcipotriol Monotherapy: A Case Report

Psoriasis is an inflammatory, immune-mediated, persistent, and multifactorial skin disease. Chronic plaque psoriasis is the most common clinical form of psoriasis. Pro-inflammatory cytokines play a primary role in the pathogenicity of this disease. Psoriasis is mainly diagnosed using clinical and dermoscopic examination of the cutaneous lesions, and skin biopsy is used in atypical cases. Psoriasis has no definitive cure. However, several topical agents are effective in managing mild and chronic cases. Combination therapy with these topical agents is more effective than with a single agent. We report a case of chronic plaque psoriasis in a 33-year-old man presenting with an itchy circumscribed, erythematous, scaly plaque, and a single cutaneous lesion covering >50% of both forearms and a few lesions on the back. The right forearm was treated with calcipotriol alone, whereas the left forearm was treated with a tacrolimus and halobetasol combination with emollients to be applied twice a day on both arms. We observed treatment responses for seven days with 24-hour intervals after each application. Combination therapy yielded a better response. In conclusion, topical treatment with a combination of halobetasol and tacrolimus is more effective compared to that with a single agent while being cost-effective and causing minimal adverse effects.

Lichen planus-lupus erythematosus overlap syndrome

The combination of lichen planus and lupus erythematosus is a rarity: no more than fifty cases of overlap syndrome have been described in the world. The clinical picture of overlap syndrome is variable: patients have discoid foci of lupus erythematosus and typical flat polygonal papules of lichen planus, as well as combined manifestations in the form of lid-red plaques with central atrophy and superficial desquamation. Positive antinuclear factor is found in laboratory examination. The histopathological picture is characterized by a combination of histological signs of lichen planus and lupus erythematosus. In some cases, clinical and immunological signs of systemic lupus erythematosus are found in patients with overlap syndrome. We describe two cases of lichen planus and systemic lupus erythematosus.

Narrow-band UVB combined with compound clobetasol propionate can improve the therapeutic effect in hand eczema patients

OBJECTIVE

To explore the therapeutic effect of narrow-band UVB combined with compound clobetasol propionate on hand eczema patients.

METHODS

From June 2017 to June 2020, 102 patients with hand eczema in our hospital were recruited for this study and divided into group A (GA) and group B (GB). The 50 patients in GA were treated with narrow-band UVB irradiation only, and the 52 patients in GB were treated with compound clobetasol propionate in addition to the treatment administered to GA. The patients' general data and therapeutic effects were observed in both groups. The adverse reactions were also observed during the treatment. The severity index scores (EASI) of the pruritus and eczema areas of the skin lesions were observed before and after the therapy. The IFN-γ and IL-4 levels in the serum were tested using ELISA. After the therapy, the quality of life and any recurrences within 3 months were observed in both groups.

RESULTS

There were no differences in the baseline data between the two groups (P>0.05). The curative effect in GB was better than it was in GA (P<0.05). The incidence of adverse reactions in GB was significantly lower than the incidence in GA (P<0.05). After the therapy, the EASI scores of the pruritus and eczema areas of the skin lesions in GB were significantly lower than they were in GA (P<0.05). After the therapy, the patients' serum IFN-γ and IL-4 levels in GB were significantly better than they were in GA. After the therapy, the quality of life of the patients in GB was significantly higher than it was in in GA (P<0.05). After 3 months of therapy, the recurrence rate in GB was significantly lower than it was in GA (P<0.05).

CONCLUSION

Narrow-band UVB combined with compound clobetasol propionate is effective at treating patients with hand eczema, as it can effectively improve their clinical symptoms and is very safe.