Psoriasis vulgaris: once-versus twice-daily application of calcipotriol cream

The cause of psoriasis is still unknown. It occurs with equal frequency in both sexes. In many patients topical application alone will suffice to keep psoriasis under control. Vitamin D3 affects keratinocyte differentiation in psoiasis. Thirteen patients with mild to moderate psoriasis vulgaris were enrolled in this trial (eight men and five women), aged between 14 and 40 years. Each patient was instructed to apply calcipotriol cream once daily on the right side and twice daily on the left side for 6 weeks. The treatment assessment was based on psoriasis area severity index (PASI) at 0, 2, 4 and 6 weeks. Serum calcium was assessed prior to and at the end of treatment. Calcipotriol cream was clearly effective in psoriasis and in both sides an almost similar effect was seen. The reduction in PASI was remarkable in both sides and the change was from 7.9 (pretreatment) to 2.4 (once daily) and 2.1 (twice daily). Out of the treated patients, seven (53.8%) had complete to marked clearance of both sides. Two patients (once daily) versus three patients (twice) had moderate improvement. Mild improvement was observed in three with twice-daily and in two with once-daily application. Post-treatment serum calcium was normal in all cases. In conclusion, there was no significant difference between once- and twice-daily application of calcipotriol cream, and single night application of topical calcipotriol could be more practical and reliable, and less expensive.