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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Brunetti R., Castagna M. *, Boccardi B. *, Biondi R. *, Cervadoro G., Pingitore R. *
Università degli Studi - Pisa Scuola di Specializzazione in Clinica Dermosifilopatica
* Laboratorio di Anatomia Patologica del Dipartimento di Chirurgia
Background. This study aimed to make a clinical, histological and immunohistochemical evaluation of the effect of a microemulsion based on carboxymethylic gluconate, D-panthenol and zinc pyrithione on scalp psoriasis.
Methods. Fifteen patients with slight to moderate scalp psoriasis applied the microemulsion twice a day for thirty days and gave their informed consent to photography and biopsy before and after treatment. The tissue samples were assayed with an immunohistochemical method (APAAP) using the following monoclonal antibodies: 1) PC10 for a nuclear antigen associated with cell proliferation (PCNA); 2) MPM-2 for some particularly abundant phosphoproteins in mitotic cells.
Results. From a clinical point of view all the cases treated showed an improvement mainly with regard to the desquamative component. Under the microscope, the thickness of psoriatic lesions, using direct measurement with a micrometric lens and measuring from the basal layer to the granulose layer, was much thinner in treated patients (mean 0.24 mm, median 0.20 mm, range 0.12-0.39) compared to controls (mean 0.42 mm, median 0.46 mm, range 0.17-0.60). Before treatment, the majority of cases showed a thickness of over 0.3 mm, whereas only a minority of cases showed thickness in excess of this level after treatment.
In control lesions the percentage of PCNA-positive cells (mean 32.88% — median 34.35% — range 10.70 — 49.82) was higher than that in treated cases (mean 7.61% — median 5.3% — range 2.6 — 18.37). Before treatment almost all cases presented a percentage of positive cells greater than 20%, whereas after treatment all cases showed lower levels of positivity. With regard to the phosphoproteins recognised by MPM-2, these were reduced in treated cases (mean 13.75% — median 13.2% — range 1.06 — 24.84) compared to controls (mean 33.17% — median 33.63% — range 18.95 — 55.10). Before treatment almost all cases showed over 25% of positive cells, whereas after treatment all cases showed lower levels of positivity.
Conclusions. The use of the microemulsion in question for the treatment of scalp psoriasis resulted in a clinical improvement and morphological regression of the lesions by interfering with the proliferation and mitosis of keratinocytes.