Clinical efficacy of topical calcipotriol and methylprednisolon aseponate in the treatment of chronic plague type psoriasis and effects on apopitosis markers

91 SUMMARY Psoriasis is a common, chronic inflammatory dermatological disorder that is characterized by hyperproliferation and resistance of keratinocytes to apoptosis, possibly at the level of T cell- keratinocyte interaction. In our study, incisional biopsies were obtained from lesional skin of 30 patients with moderate chronic plaque psoriasis and 15 healthy controls to search the expression rates of apopitosis regulating genes bcl-2 and p53 and the proliferatig cell antigen ki-67. The study also compare the effects of six weeks treatment regimens of calcipotriol and corticosteroid ointments on these parameters. In addition, we compared the clinical efficacy of both regimens in the topical treatment of psoriasis vulgaris with PASI scoring system. Reduction in the PASI score was achieved with calcipotriol and MPA ointments when used twice daily for six weeks for chronic plaque psoriasis and the decrease in PASI score was found to be statisticaly significant. In our study, improvement rates favoured treatment with MPA. Clinical and histopathological assesments did not reveale any adverse events. In psoriasis patients, after six weeks treatment period, we detected a decreased expression of p53 and ki-67 in association with an increase in the bcl-2 expression. At the end of the treatment, no significant difference was found between the two groups with respect to expression rates of proteins p53 and bcl-2 in psoriatic keratinocytes. This finding suggests that the keratinocyte apopitosis, which is thought to be reduced in psoriasis, is rearranged in healing lesions in a way that is not interrelated to the therapeutic regimen. In conclusion, calcipotriol ointment is a safe and efficacious treatment modality for chronic plaque psoriasis when it is used twice daily for six weeks. MPA ointment also is another efficient and safe therapeutic alternative in the treatment of chronic plaque psoriasis.