Journal of Clinical and Aesthetic Dermatology

MAY 2018

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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29 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY May 2018 • Volume 11 • Number 5 O R I G I N A L R E S E A R C H was 3.9±2.8, demonstrating a change of 45.1 percent from baseline. Scaling decreased 4.4±2.8 from baseline to Week 4 and, at Week 16, the mean scaling score was 3.1±2.3 for a change from baseline of 37.5 percent. The mean Scalpdex score was reduced 28.5±22.5 points from baseline to a mean score of 36.6±18.9 points at Week 4 and 38.9±20.0 points at Week 16, representing a decrease of 25.9±18.5 points (40.8%) from baseline. Safety results. There were a total of 19 adverse events (AEs) that occurred in nine subjects. The most common AEs overall were burning sensation in five subjects and itching in three subjects. Nine of the 19 AEs were considered treatment-related and occurred in seven subjects, or 35 percent of the study population. Additional AEs that were considered treatment-related were folliculitis in one subject and acne in two subjects. DISCUSSION This open-label, observational study of desoximetasone 0.25% topical spray to treat scalp psoriasis indicates that this treatment is safe and effective. Onset of action was rapid across all efficacy parameters, with significant improvements seen as early as Week 4 after initiation of treatment, thus optimizing initial control. PGA, BSA, BSA×PGA, scalp IGA, and PSSI were reduced from baseline by 55, 51, 63, 65, and 82.4 percent, respectively. After four weeks, desoximetasone 0.25% spray was decreased from twice-daily application to twice-daily application on two consecutive days per week from Week 4 through Week 16. Improvements from baseline were maintained at Week 16. At Week 16, PGA and scalp IGA were reduced from baseline by approximately 50 percent. Additionally, PSSI was reduced by 63.4 percent at Week 16. CONCLUSION Taken together, our findings demonstrate that desoximetasone 0.25% topical spray prompts rapid and significant improvement in scalp psoriasis. This level of efficacy combined with the convenience and the use of a patient-preferred spray vehicle suggest that this is an effective therapy for scalp psoriasis. A larger, randomized, controlled trial should be initiated in order to corroborate and extend these results. REFERENCES 1. Greaves MW, Weinstein GD. Treatment of psoriasis. New Engl J Med. 1995;332(9):581–588. 2. Camp RDR. Psoriasis. In: Champion RH, Burton JL, Burns DA, Breathnach SM, eds. Textbook of Dermatology. Vol. 2. 6th ed. Hoboken, NJ: Wiley- Blackwell; 1999: 1589–1649. 3. Wozel G. Psoriasis treatment in difficult locations: scalp, nails, and intertriginous areas. Clin Dermatol. 2008;26(5):448–459. 4. Kragballe K. Management of difficult to treat locations of psoriasis. Scalp, face, flexures, palm/soles and nails. Curr Probl Dermatol. 2009;38:160–171. 5. Zeichner JA, Lebwohl MG, Menter, A et al. Optimizing topical therapies for treating psoriasis: a consensus conference. Cutis. 2010; 86(3 Suppl): 5–31. 6. Ortonne JP, Ganslandt C, Tan J, et al. Quality of life in patients with scalp psoriasis treated with calcipotriol/betamethasone dipropionate scalp formulation: a randomized controlled trial. J Eur Acad Dermatol Venereol. 2009;23(8):919–926. 7. Keegan BR. Desoximetasone 0.25% spray for the relief of scaling in adults with plaque psoriasis. J Drugs Dermatol. 2015; 14(8):835–840. 8. Kircik L, Lebwohl MG, Del Rosso JQ, et al. Clinical study results of desoximetasone spray 0.25% in moderate to severe plaque psoriasis. J Drugs Dermatol. 2013;12(12):1404–1410. 9. Chen SC, Yeung J, Chren M. Scalpdex: a quality of life instrument for scalp dermatitis. Arch Dermatol. 2002;138(6):803–807. JCAD FIGURE 1. Psoriasis Scalp Severity Index (PSSI) mean scores FIGURE 2. Changes from baseline for subject-reported symptoms 4.8±5.2

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