Clinical Efficacy and Safety of a Combined Formulation of Zinc Pyrithione 0.25% and Betamethasone Dipropionate Micronized 0.05% in the Treatment of Mild to Moderate Plaque Psoriasis

Background Psoriasis is a common chronic inflammatory skin disease characterized by erythematous and scaling plaques. The ongoing understanding of its pathogenesis has led to new therapeutic options and new areas of research which aimed at reducing keratinocyte proliferation and suppressing T-cell activation. Objectives To evaluate the efficacy and safety of topical use of a combined formulation of zinc pyrithione 0.25% and betamethasone dipropionate micronized 0.05% in a base of isopropyl myristate used in mild to moderate plaque psoriasis. Methods A total of 32 patients were enrolled into a prospective open clinical trial. Patients were first treated with the combined formulation of zinc pyrithione and betamethasone dipropionate, which was topically administered twice daily for two weeks. After the 2 week of therapy, zinc pyrithione emulsion alone was applied twice daily for two weeks and twice daily two to three times a week for the following two weeks. Efficacy and safety were assessed. Results Our results showed that the combination of zinc pyrithione 0.25% and betamethasone dipropionate micronized 0.05% in a base of isopropyl myristate rapidly reduced erythema, thickness and scaling. Clinical improvement and Psoriasis Area and Severity Index (PASI) reduction occurred in less than two weeks of therapy. The maintenance product, zinc pyrithione alone, was able to complete the clinical remission, reduce the frequency of recurrences and avoid a long term use of topical corticosteroids. Adverse reactions, such as lesional/perilesional dryness and mild itching, occurred in 12.5% of all patients (4/32), but improved throughout therapy by applying an emollient once daily when needed. Conclusions Our findings suggest that a combined formulation of zinc pyrithione 0.25% and betamethasone dipropionate micronized 0.05% in a base of isopropyl myristate is an effective and well tolerated topical treatment worthy of consideration for patients with mild to moderate plaque psoriasis.