Comparison Study of tacrolimus ointment 0.1% and topical hydrocortisone cream 2% for treatment of facial psoriasis in adult patients: a 8-week randomized controlled trial

Somsak Towanabut; Poohglin Tresukosol

Authors

Somsak Towanabut THE INSTITUTE OF DERMATOLOGY, BANGKOK, THAILAND
Poohglin Tresukosol THE INSTITUTE OF DERMATOLOGY, BANGKOK, THAILAND

Keywords:

facial psoriasis, topical calcineurin inhibitors, tacrolimus 0.1%, topical corticosteroids, hydrocortisone cream 2%

Abstract

Background: Facial psoriasis is a chronic skin rash which ofter lead to embarrassment and decreases patient’s quality of life. Topical corticosteroid have been used but was limited by its longterm local cutaneous side effects. Topical tacrolimus which is an anti inflammatory and immunosuppressive drug was used successfully to treat psoriasis on the face with minimal side effects.

Objective: To determine the efficacy and safety of topical tacrolimus ointment 0.1% in comparison with topical hydrocortisone cream 2% (2% HC) in adult patients with facial psoriasis.

Materials and methods: Thirty-one of 34 patients with facial psoriasis completed 8 weeks trial with twice daily application of tacrolimus ointment 0.1% on one facial half and hydrocortisone cream 2% (2% HC) on the contralateral site base on random assignment. Photographs were taken at 1^st visit, 2^nd, 4^th and 8^th week after treatment. Three blinded dermatologists evaluated clinical outcome using Physician’s Global Assessment (PGA) score, Targeted Area Score (TAS) and Overall Severity Score compared to baseline. Adverse effects and patient self-assessment were done at the same time.

Results: No significant difference was observed between topical tacrolimus ointment 0.1% and 2 % HC group using Physician’s Global Assessment (PGA) score of clear or excellent improvement (90-100 % improvement) after 8 weeks of treatment. Statistically Significant improvement (p < 0.05) was achieved by TAS scales at 2^nd, 4^th and 8^th week, induration score at 8^th week of treatment and the Overall Severity Score at 2^nd, 4^th and 8^th week of treatment with tacrolimus ointment 0.1% group compared with 2% HC Tacrolimus ointment 0.1% was well tolerated with minimal side effects such as only transient burning, itching, irritation and acneiform eruptions.

Conclusion: Topical tacrolimus ointment 0.1% is a safe and effective treatment for facial psoriasis similar to 2%HC.

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