Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Psoriasis is a common chronic condition of the skin that is resistant to many therapies. There is a
need for the development of novel non-steroidal topical drugs for the treatment of psoriasis.
OBJECTIVE:
To assess the efficacy and safety of topical podophyllin 5% ointment in patients with mild plaque-
type psoriasis.
PATIENTS AND METHODS:
Sixty two patients with mild plaque-type psoriasis were enrolled in this study. They were divided
into 3 groups: GroupA (21patients)were treated with podophyllin 5% ointment every other day,
while Group B(20patients)were treated with clobetasol propionate 0.05%ointment twice daily and
21 patients in Group C were treated with Vaseline twice daily for 8 weeks as a control group.
Efficacy was evaluated every 2 weeks for 8weeks using Psoriasis Area and Severity Index (PASI)
score and relapse was recorded after cessation of treatment in those patients who achieved good
response during 8 weeks follow up period.
RESULTS:
A total of 62patients were 44(70.9%) males and 18(29.0%) females, with: male: female ratio 2.3:1.
Their ages ranged from 18-65 (37.5±12.9) years. Their baseline PASI score ranged from 1.29(5.2±2.4).

At
the
end
of
8
weeks
of
therapy
:
no
statistically
significant
difference
in
PASI
reduction
between

Group

A(66.3±20.7) and Group B(68.1±34.2) treated patients, P-value =0.831 and both of them
were statistically significant higher PASI reduction than patients with Group C,34.1±28.8, P-value
=<0.001.Regarding the percentage of patients who achieved good response, there was no
statistically significant difference between Group Aand Group B, 95.3% versus 70% ( Pvalue=0.083)

and both of them achieved a statistically significant higher percentage of patients
with good response than Group C,47.6%, P-value=<0.001. Although the percentage of patients
with complete clearance (PASI≥90%) in the Group Awas much less, 9.5%, than that of Group B,
65% (statistically significant, P-value=< 0.001), the total relapse rate during 8 weeks follow up was
much lower among Group Apatients, 25% versus 70%, P-value=0.043.On the other hand no
complete clearance was achieved in the Group Cand their relapse rate was 80%.
Regarding side effects: Group A, 9.5% of patients developed hypopigmentation, Group B, 10% of
patients developed pyoderma and Group C, no side effects were reported. There was no statistically
significant difference among the three groups regarding the frequency of side effects (P = 0.355).
CONCLUSION:
Podophyllin 5% ointment on every other day regimen was as effective as clobetasole 0.05%
ointment twice daily at the end of 8 weeks treatment with no side effects and with a much lower
relapse rate.