Topical treatments for scalp psoriasis review

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This review looked at treatments for scalp psoriasis.

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Abstract:
People with chronic plaque psoriasis often have lesions on the scalp that are difficult to treat. This is a summary of a Cochrane review on efficacy and safety of topical treatments for scalp psoriasis. For quality of evidence assessment, we used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group approach. Only randomised controlled trials (RCTs) were eligible for inclusion.

We searched the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, EMBASE and LILACS, ongoing trials, index of included studies and screened abstracts of six psoriasis-specific conferences up to August 2015.

We included 59 RCTs, with overall 11,561 participants. Most findings were limited to short-term treatments (< six months). According to the clinician and patients’ self-assessment a corticosteroid/vitamin D combination (e.g. betamethasone dipropionate plus calcipotriol) and corticosteroids of high and very high potency were better than vitamin D. The two-compound combination was superior to the corticosteroid alone, but the additional benefit was small. Reporting of quality of life data was insufficient. The two-compound combination and corticosteroids caused fewer withdrawals due to adverse events (AEs) than vitamin D. There was no difference between the two-compound combination and corticosteroid monotherapy concerning this outcome. Overall evidence was of moderate quality. Evaluation of other topical treatments was limited.

Given the comparable safety profile and only slim benefit of the two-compound combination over the corticosteroid alone, monotherapy with generic topical corticosteroids of high and very high potency may be fully acceptable for short-term therapy. More quality of life data and long-term assessments are needed.

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Source: onlinelibrary.wiley.com