Dithranol in an Emulsifying Oil Base (Bio-Wash-Oil) for the Treatment of Psoriasis of the Scalp

Abstract

On the scalp, dithranol has been studied in only a few trials. The dithranol molecule that contains both hydrophilic and lipophilic centers can be incorporated into detergents and allows easy removal from hair. This property has led to the incorporation of dithranol in an emulsifying oil base (bio-wash-oil). The formulation has been used routinely for more than two decades in East Germany. We reexamined the efficacy and safety of dithranol in bio-wash-oil and compared it to dithranol embedded in crystalline monoglycerides (Micanol^®) in patients with psoriasis of the scalp. In a prospective, parallel group study, 64 patients attending a day-care clinic were randomly allocated to 3 treatment groups: (1) dithranol in bio-wash-oil; (2) Micanol^® cream, and (3) Micanol^® cream in bio-wash-oil. Treatment was carried out for 3 weeks and results assessed using a modified Psoriasis Area and Severity Index score. Dithranol in bio-wash-oil resulted in a reduction in the score of 34% on day 7 and 57% on day 14. This was significantly better than in groups 2 and 3, as were the overall response and patients’ assessment at the end of treatment (p < 0.05). Dithranol in a bio-wash-oil is an effective, well-tolerated and low-priced treatment in psoriasis of the scalp.

Treatment of severe scalp psoriasis: From the Medical Board of the National Psoriasis Foundation

“…51 It is reported to have some efficacy against pruritus 36 and may be beneficial as adjunctive therapy. Anthralin has been useful in the treatment of psoriasis for over 8 decades and is effective for scalp disease, 25 but its use is also Table I. limited by side effects, including irritation and staining of the skin. 36 Clinical studies demonstrating the efficacy of tazarotene in scalp psoriasis are lacking.…”

“…Phototherapy is an established therapeutic approach for the treatment of psoriasis, but is difficult to use on the scalp because of the presence of hair, which prevents adequate penetration of ultraviolet (UV) rays. Previously reserved for 25 IIB d Open-label study; 64 pts; dithranol in biowash oil for 3 wk d Modified PASI score reduction of 34% on day 7, 57% on day 14, and significant reduction at end of study mo, Month; for other abbreviations, see Table I. J AM ACAD DERMATOL VOLUME 60, NUMBER 6 balding patients or those with thin scalp hair, phototherapy may now be practical in patients with thick hair by the use of a specially designed UV comb. [31][32][33] The excimer laser provides narrowband UVB (308 nm) phototherapy with a very high irradiance, allowing for a shorter treatment time.…”

Gene expression profiling in psoriatic scalp hair follicles: clobetasol propionate shampoo 0.05% normalizes psoriasis disease markers

“…Patients were asked to estimate their level of pruritus (on a scale from 0 to 3, with 0 = none to 3 = severe) at each visit. At the end of the study, Total Severity Score (TSS) was calculated as TSS = E + S + P, and Modified Psoriasis Area and Severity Index (MPASI) was calculated as MPASI = (E + S + P) × Ex 31 …”

“…At the end of the study, Total Severity Score (TSS) was calculated as TSS = E + S + P, and Modified Psoriasis Area and Severity Index (MPASI) was calculated as MPASI = (E + S + P) · Ex. 31…”

Topical therapies in psoriasis

“…It is effective in short and long contact regimens. It is particularly useful for scalp psoriasisNew formulations in emulsifying ointment base with 0.1% w/w ascorbyl palmitate as an anti-oxidant are stable for up to 52 weeks[30]Dithranol, in an emulsifying oil base (bio-wash oil), is useful for scalp psoriasis[31]Liposomal dithranol (lipogel) is an effective formulation with less irritation and staining. [32]…”