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Topical treatments for chronic plaque psoriasis : an abridged Cochrane systematic review
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Mason, Anne, Mason, James, Cork, Michael, Hancock, Helen and Dooley, Gordon (2013) Topical treatments for chronic plaque psoriasis : an abridged Cochrane systematic review. Journal of the American Academy of Dermatology, 69 (5). pp. 799-807. doi:10.1016/j.jaad.2013.06.027
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Official URL: http://dx.doi.org/10.1016/j.jaad.2013.06.027
Abstract
Background:
Chronic plaque psoriasis is the most common type of psoriasis and is characterized by redness, thickness, and scaling. First-line management is with topical treatments.
Objective:
We sought to undertake a Cochrane review of topical treatments for chronic plaque psoriasis.
Methods:
We systematically searched major databases for randomized controlled trials. Trials reported improvement using a range of related measures; standardized, pooled findings were translated onto a 6-point improvement scale.
Results:
The review included 177 randomized controlled trials with 34,808 participants, including 26 trials of scalp psoriasis and 6 trials of inverse and/or facial psoriasis. Typical trial duration was 3 to 8 weeks. When compared with placebo (emollient base), the average improvement for vitamin-D analogues and potent corticosteroids was approximately 1 point, dithranol 1.2 points, very potent corticosteroids 1.8 points, and combined vitamin-D analogue plus steroid 1.4 points once daily and 2.2 points twice daily. However, these are indicative benefits drawn from heterogeneous trial findings. Corticosteroids were more effective than vitamin D for treating psoriasis of the scalp. For both body and scalp psoriasis, potent corticosteroids were less likely than vitamin D to cause skin irritation.
Limitations:
Reporting of benefits, adverse effects, and safety assessment methods was often inadequate. In many comparisons, heterogeneity made the size of treatment benefit uncertain.
Conclusions:
Corticosteroids are as effective as vitamin-D analogues and cause less skin irritation. However, further research is needed to inform long-term maintenance treatment and provide appropriate safety data.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Medicine > Warwick Medical School | ||||||
| Journal or Publication Title: | Journal of the American Academy of Dermatology | ||||||
| Publisher: | Mosby, Inc. | ||||||
| ISSN: | 0190-9622 | ||||||
| Official Date: | November 2013 | ||||||
| Dates: |
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| Volume: | 69 | ||||||
| Number: | 5 | ||||||
| Page Range: | pp. 799-807 | ||||||
| DOI: | 10.1016/j.jaad.2013.06.027 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access |
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