Mohammad Majid Paracha.
Efficacy and safety of cryotherapy and clobetasol propionate ointment (0.05%) in treatment of localized plaque psoriasis: a randomized controlled trial.
J Pak Assoc Derma Jan ;31(3):489-94.

Background  Psoriasis is a chronic, immune-mediated and genetic based dermatoses, characterized by accelerated cell proliferation of keratinocytes and by the inflammation that results in parakeratotic scales. Treatment may be topical or systemic. Use of clobetasol propionate, a synthetic glucocorticoid with high power, is already known and widely used. Cryotherapy is the application of intense cold to cause tissue necrosis by rapid freezing.  Objective We sought to compare the efficacy and safety of cryotherapy and clobetasol propionate ointment (0.05%) in treatment of localized plaque psoriasis.  Methods A total of 74 patients (37 patients in each group) were included in the study. Patients in group A were subjected to cryotherapy with liquid nitrogen. Patients in group-B were subjected to 0.05% clobetasol ointment. The lesions were assessed four weeks after starting treatment by using Visual Analogue Scale.  Results  In group-A mean age of the patients was 30.3±8.1 and in group-B 25.3±9.7 years. There were 22 males (59.5%) in group-A and 15 males (40.5%) in group-B while 15 females (40.5%) in group-A and 22 females (59.5%) in group-B. Cryotherapy was efficacious in 19 patients (51.4%) and clobetasol was efficacious in 33 patients (89.2%). The difference between two groups was statistically significant (p≤0.001). Similarly, clobetasol group was safer than cryotherapy (p=0.002). Outcome of VAS at 4 weeks in group-A vs. group-B was as follows: Complete 9 (24.3%) vs. 25 (67.6%), moderate 10 (27%) vs. 8 (21.6%) and mild 18 (48.7%) vs. 4 (10.8%).  Conclusion  This study shows that clobetasol propionate ointment (0.05%) is significantly more effective and safer as compared to cryotherapy in the treatment of localized plaque psoriasis.

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