Epidermal differentiation characteristics of the psoriatic plaque during short contact treatment with dithranol cream

• Published in: Clinical and experimental dermatology 1996-11, Vol.21 (6), p.409-414
• Main Authors: VAN DER VLEUTEN, C.J.M., DE JONG, E.M.G.J., VAN DE KERKHOF, P.C.M.
• Format: Article
• Language: English
• Subjects: Administration, Cutaneous; Adult; Anthralin - therapeutic use; Biological and medical sciences; Cell Differentiation - drug effects; Chronic Disease; Epidermis - drug effects; Epidermis - pathology; Female; Humans; Immunohistochemistry; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Psoriasis - drug therapy; Psoriasis - pathology; Skin, nail, hair, dermoskeleton; Staining and Labeling
• ISSN: 0307-6938; 1365-2230
• DOI: 10.1111/j.1365-2230.1996.tb00143.x

Summary Dithranol has been used successfully in the treatment of psoriasis for more than 75 years, and much in vitro anti in vivo research has been done on the elucidation of the mode of action of this potent and safe antipsoriatic therapy. In vivo research has research major effects of dithranol on epidermal proliferation and inflammation‐ Information on the in vivo effects on epidermal differentiation is limited. Therefore, the dynamics of a set of differentiation markers (keratin 16, filaggrin, keratinocyte transglutaminase, involucrin) and markers for proliferation and inflammation (Ki‐67, T lymphocytes, polymorphonuclear leucocytes) were studied in skin biopsies of six patients with psoriasis during 4 weeks of dithranol therapy. The treatment regimen involved a short contact protocol at our out‐patient day treatment centre with an easily washed off cream. Treatment resulted in a decrease of the PASI score of 48° in 4 weeks. Immunohistochemically, a major decrease of keratin 16 content and virtually complete restoration of the filaggrin positive cell layer were seen. These changes proved to be significant by comparison of the markers over the group of six patients. Although many other topical treatments for psoriasis (occlusive therapy and vitamin D3 analogues) result in a prominent reduction in the amount of transglutaminase and involucrin positive cell layers, the effect of dirhranol on these markers is minimal.