Comparative Efficacy and Safety of Topical 1% Methotrexate Gel and 0.1% Betamethasone Valerate Ointment in Treatment of Palmoplantar Psoriasis using Iontophoresis

Sanjeetha Fathima, S (2020) Comparative Efficacy and Safety of Topical 1% Methotrexate Gel and 0.1% Betamethasone Valerate Ointment in Treatment of Palmoplantar Psoriasis using Iontophoresis. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Palmoplantar psoriasis is a variant form of psoriasis that characteristically affects the skin of the palms and soles and comprises 3-4% of all cases of psoriasis. Palmoplantar psoriasis is notoriously refractory to conventional therapy. Methotrexate were tried topically to avoid systemic toxicity. Iontophoresis was used as drug delivery mode to increase the percutaneous penetration. AIM OF THE STUDY: 1. To find a safe and effective drug in the treatment of Palmoplantar psoriasis and to improve their quality of life. 2. To compare the efficacy and safety of topical Methotrexate gel 1% and topical Betamethasone valerate 0.1% in treatment of palmoplantar psoriasis using Ionotophoresis as drug delivery vehicle. METHODOLOGY: 102 palmoplantar psoriasis patients were selected randomly. They were divided into two groups, Group A (topical methotrexate gel) n=51 and Group B (topical betamethasone valerate ointment) n=51. All the patients were instructed to apply respective topicals once a day & subjected to Iontophoresis weekly once. Clinical assessment was done on 2nd, 4th, 6th and 8th week respectively based on, Erythema, Scaling & Fissuring with each parameter scored on a scale of 0–3. (0 - clear, 1 - mild, 2 - moderate and 3 - severe), during each visit. QOL of patient was assessed before and after treatment using DLQI questionnaire. RESULTS: In this study females (60.8 %) outnumbered the males, Plantar psoriasis was the predominant site involvement followed by palmar psoriasis. Only 7.2% patients have family history of psoriasis. 20.6% have nail involvement. Associated co morbidities were16.5% patients are hypertensives, 10.3% are diabetics & 3.1% are hypothyroid patients. At the end of 2nd week, significant change in erythema was found among study groups. At the end of 4th week, significant change in erythema, scaling, fissuring was found in both groups. At the end 8th week, in group A, 69.9% and 49.9% of patients showed clearance of scaling and fissuring respectively. In group B, 33% and 12.5% of patients showed clearance of scaling and fissures. CONCLUSION: Topical 1% Methotrexate gel was better than topical betamethasone because of its faster clearance, low recurrence, fewer side effects and drastic improvement with QOL. It highlights the importance of Iontophoresis which increase the drug penetration and show higher rate of clearance of lesion.

Item Type: Thesis (Masters)
Additional Information: 201730057
Uncontrolled Keywords: Quality Of Life, Iontophoresis, dermatology life quality index.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Feb 2021 02:01
Last Modified: 05 Feb 2021 02:01

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