Significant Reduction in the Extent and Intensity of Psoriasis After Initiating Therapy with Skin Foam − Case Study

Personal and Family Medical History

The patient (24 years old) has been dealing with psoriasis for more than 10 years, with the first symptoms appearing at age 13. His overall health is good, and he does not have any comorbidities associated with psoriasis. He does not take any permanent medication and denies any allergies. In childhood, he had Lyme disease and underwent surgery for a herniated disc during puberty. Other than that, his personal medical history is insignificant. The patient is slim, smokes an average of 10 cigarettes a day, and consumes alcohol occasionally. He is single, childless, and works as a laborer in the automotive industry. In his free time, he engages in football and cycling, and these activities are limited by his psoriasis. There is no history of psoriasis or other skin diseases in his family medical history; his mother is treated for arterial hypertension, his father has experienced a stroke, and his sister is healthy.

Description of Complaints

The first symptoms of psoriasis appeared on the scalp and gradually spread to the upper and lower extremities and the trunk. There was never a long-term remission in the scalp area. Nail involvement was not and is not evident, and the patient does not suffer from psoriatic arthropathy. However, the manifestations of psoriasis have been variable over the past two years. During the first visit to the dermatovenerology clinic, extensive involvement was noted, affecting 27% of the body surface area (BSA). The assessment of the extent and intensity of psoriasis using the PASI score was 14.4. The patient reported mild itching of psoriatic lesions.

Trunk involvement before starting skin foam therapy

Psoriasis manifestations on the lower extremities before starting skin foam therapy

Previous Therapy

In the past, the man was under the care of an outpatient dermatologist, with treatment intervals involving various topical corticosteroids. Usually, it was betamethasone dipropionate with salicylic acid in the form of an ointment. However, the therapeutic effect was always only temporary, and complete healing was never achieved. The patient also used emollients (Cremor leniens) and utilized Linola Fett Ölbad for hygiene. He never underwent phototherapy or spa therapy.

Change in Treatment

At the first visit to the dermatovenerology clinic, the effect of the previous treatment was assessed as insufficient, and instead of local corticosteroids, treatment with a fixed combination of 0.005% calcipotriol and 0.065% betamethasone dipropionate in the form of skin foam was initiated. Emollients remained unchanged. After 4 weeks of treatment, the new therapy showed an effect – the Physician Global Assessment (PGA) was rated at level 1, and the patient rated it at level 2. According to him, the tolerability of the skin foam was excellent, with no skin irritation or other adverse effects. He rated the cosmetic acceptability as excellent, despite initial feelings of cold immediately after applying the foam.

Evaluation after 3 Months

After 3 months of therapy, the affected BSA reduced to 10%. The PGA rating remained at level 1. The patient was very satisfied with the skin foam, particularly highlighting its excellent cosmetic acceptability and ease of application compared to previous treatments. He continues to use the foam daily on residual manifestations of psoriasis.

State after treatment with skin foam

Effect of skin foam therapy on the lower extremities

Summary and Conclusion

The extensive manifestations of psoriasis, affecting up to 27% BSA, limited the young patient, particular due to the visibility of the lesions. Thanks to the new therapy using skin foam with a fixed combination of calcipotriol and betamethasone dipropionate, which significantly reduced the extent of the affliction, he feels more comfortable. A degree of healing was achieved that was never reached during previous treatments with topical corticosteroids in the ointment form.

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Source: Šternberský J. Young man with BSA 27-case study. Clinic of Skin and Venereal Diseases, Faculty of Medicine, Palacky University, and University Hospital Olomouc, 2020.