Topical treatments for scalp psoriasis

Area of Science:

• Dermatology
• Pharmacology

Background:

• Scalp psoriasis presents treatment challenges due to hair and sensitive adjacent facial skin.
• Topical treatments are commonly used but require careful assessment for efficacy and safety.

Purpose of the Study:

• To evaluate the effectiveness and safety of various topical treatments for scalp psoriasis.
• To compare corticosteroid monotherapy, vitamin D monotherapy, and combination therapies.

Main Methods:

• Systematic review and meta-analysis of 59 randomized controlled trials (RCTs) involving 11,561 participants.
• Searched multiple databases up to August 2015, including Cochrane, MEDLINE, and EMBASE.
• Assessed outcomes such as lesion clearance, treatment response (Investigator's Global Assessment and Patient's Global Assessment), and adverse events.

Main Results:

• Corticosteroids were more effective than vitamin D for both clearance and response (moderate to high quality evidence).
• A two-compound combination of steroid and vitamin D showed superiority over steroid monotherapy, but with a small additional benefit (moderate quality evidence).
• Corticosteroids and combination therapies resulted in fewer treatment withdrawals due to adverse events compared to vitamin D (moderate to high quality evidence).

Conclusions:

• Both combination therapy and corticosteroid monotherapy are more effective and safer than vitamin D monotherapy for scalp psoriasis.
• Topical steroid monotherapy is a fully acceptable option for short-term treatment due to its safety profile and comparable efficacy to combination therapy.
• Future research should focus on quality of life improvements and long-term treatment outcomes (6-12 months).