Management of intertriginous psoriasis (IP) usually includes the application of topical corticosteroids, but those medications have adverse effects with long-term use. Fortunately, a study has revealed that a short-term application of topical corticosteroids and maintenance with a less potent agent can offer a reasonable approach for treating patients with IP.

From Bio-Medicine:

In this study, Alexander Kreuter, M.D, from Ruhr University of Bochum, Germany, and colleagues conducted a randomized controlled trial that compared 1 percent pimecrolimus (a new anti-inflammatory drug), 0.005 percent calcipotriol, 0.1 percent betamethasone and the vehicle (a similarly appearing cream with no active drug) in the treatment of IP with a four-week treatment period and a six-week follow-up without therapy. A total of 80 adult patients with the clinical diagnosis of IP were included, 20 patients in each of the four treatment groups.

The researchers report 25 percent of patients treated with pimecrolimus reported an increase in itching and burning shortly after application, however, most reactions lasted less than 30 minutes and resolved in a few days.

“In conclusion, this study indicated the efficacy of all three active compounds, 1 percent pimecrolimus, 0.1 percent betamethasone, and 0.005 percent calcipotriol (as well as the vehicle) in the treatment of IP. The 0.1 percent betamethasone was clearly more effective than 1 percent pimecrolimus, confirming that treatment with corticosteroids is still the most effective topical approach for psoriasis. However, their use in long-term management, particularly for the treatment of intertriginous areas is limited.

Psoriasis is an inflammatory skin disease. In a subset of patients, psoriasis is located in the intertriginous areas, including the skin folds of the underarms, breasts, groin, buttocks and genitals, according to background information in the article. Patients who exhibit IP complain about intense itching, irritation from sweating and soreness. These symptoms may have devastating psychological and emotional consequences.

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