PSORIASIS DE CERCA

THE RETURN OF COALTAR - EL REGRESO DEL ALQUITRÁN.

Extracto del informe de la conferencia de DERMATOLOGÍA celebrado en Las Vegas el 8 de Octubre de 2.010.

INFORME COMPLETO

El alquitrán ha regresado. Había caído en el olvido por ser poco cosmético ya que posee un desagradable olor y su uso es farragoso. Además ha sido sustituido por otras terapias tópicas desarrolladas en las últimas décadas. Pero la realidad es que funciona realmente bien. Ha sido utilizado durante años, bien solo o en combinación de fototerapia. Su seguridad como medicamento fue revisada y reafirmada por la FDA en 2.001.
El tratamiento de Goeckerman, que combina fototerapia y alquitrán, es muy efectivo: Algunos estudios han mostrado que posee el 90% de efectividad en tan solo 18 días, y el resultado es duradero, con remisiones que en muchos casos pueden llegar a 8 meses.
Los nuevos productos utilizan distintos vehículos, incluyendo una solución líquida y una espuma.
La solución (Psorent) utiliza un 15% de "Liquor Carbonis Distillate" (LCD), que se seca rápidamente y que se acompaña de un aplicador, por lo que el paciente no tiene que tocar el preparado. Se han realizado estudios con pacientes con psoriasis moderada, y se ha comparado con la utilización de CALCIPOTRIOL en crema dos veces al día en casa durante 12 semanas. (…) Los resultados fueron mejores después de 12 semanas de tratamiento. (…)

(…)

La espuma de alquitrán al 2% (SCYTERA) que ha salido al mercado recientemente es un producto cosméticamente muy avanzado, permitiendo un secado rápido en la piel, y con características de eficacia comparables con una crema de Calcipotriol después de 8 semanas de utilización, (…) proporcionando al paciente un vehículo y fragancia muy adecuados para su aplicación y mejorando a la tradicional fórmula de alquitrán.

  

        Tratamiento de Goeckerman.

Coal tar is making a comeback; it had fallen out of favor because it has an unpleasant smell and is messy to use. In addition, many other options for topical therapy have been developed. The truth is, tar works fairly well. It’s been around for a long time, and can either be used alone or in combination with UV therapy.The safety of medicinal tar was reviewed and reaffirmed by the FDA in 2001.8

Goeckerman treatment, which utilizes UV therapy and tar, is very effective: Some studies have shown that it’s about 90% effective in as little as up to 18 days, and that treatment is durable, with remission lasting in many cases up to 8 months.9 The new products have different vehicles, includ- ing a solution and a foam.

The solution (Psorent) is a 15% liquor carbonis distillate (LCD), quick-drying transparent vehicle that comes with a dabber, so the patient doesn’t have to touch it. Studies were done in patients with moderate psoriasis comparing the use of the LCD solution or a commercially available calcipotri- ol cream twice daily at home for 12 weeks.10–12 The researchers found that the LCD was superior to the vitamin D cream in terms of achieving a PASI 50 as well as in achieving a PASI 75 after 12 weeks.They also found a sim- ilar durable response as is seen in Goeckerman-treated patients. The relapse rate after 6 weeks was significantly lower than in patients treated with the vitamin D cream.

Patients also tolerated the solution quite well. One important study looked at whether or not this LCD solu- tion discolored bleached hair, finding it did not, which opens up the formulation for use on the scalp.12 Ameliorative effects kick in fairly quickly — within 2 weeks — with the solution used as monotherapy.8

This tar liquid was also studied in combination with nar- row-band light.A small pilot study comparing the combi- nation of the tar liquid with narrow-band UVB to narrow- band UVB alone showed that, after 4 weeks, there was sta- tistically significant improvement with the combination therapy.13 At the end of 12 weeks, the two groups were roughly the same, but patients achieved full efficacy faster with the combination.

The coal tar foam 2% (Scytera) that recently came to market is aesthetically advanced; spreads easily and dries quickly; and features comparable efficacy to calcipotriene cream after 8 weeks.14 It’s available as a behind-the-count- er product and has more patient-acceptable vehicle and fragrance than traditional tar.14