Efficacy of Calcipotriol/Betamethasone Dipropionate Fixed-Combination Aerosol Foam in the Treatment of Localized Scalp Psoriasis: A Real-Life Case Series from Switzerland

INTRODUCTION: Scalp psoriasis is one of the most common and challenging manifestations of plaque psoriasis for general practitioners, dermatologists, and patients, as successful topical management requires the choice of effective ingredients, an appropriate formulation, and clear application instructions to patients. To date, only limited experience is available for the calcipotriol (50 μg/g)/betamethasone dipropionate (0.5 mg/g) aerosol foam formulation (Cal/BD foam) in the treatment of scalp psoriasis. METHODS: In this Swiss real-world patient case series, we asked 10 consecutive patients with active scalp psoriasis to apply the Cal/BD foam once daily before bedtime for a period of 4 weeks. Clear application and rinse-off instructions were provided. RESULTS: A total of 10 consecutive adult patients were treated between April and May 2019. Two patients suffered from mild, five from moderate, and three from severe scalp psoriasis. In eight out of the 10 patients, scalp psoriasis was the only manifestation of disease. All patients had received previous topical treatments, mainly topical corticosteroids (TCS), tar shampoo, and salicylic acid. After 4 weeks of treatment with Cal/BD foam, the scalp psoriasis improved in all 10 patients by ≥ 2 points on a 5-point severity assessment scale. Eight out of 10 patients achieved clear/almost clear skin after 4 weeks of treatment, with no further keratolytic treatments needed. Adverse events were not observed in any of the patients. Overall, patients were very satisfied with the ease of use, the efficacy, and the safety of the Cal/BD foam. CONCLUSION: Our case series confirms that Cal/BD foam is a rapid, effective, and convenient treatment for localized scalp psoriasis in a nonselected real-world patient cohort refractory to TCS or other local treatments. Clear application instructions are crucial for treatment success and cosmetic acceptance, however.