A Comparative Cross-Sectional Study of Short-term Clinical Outcomes of Topical Clobetasol versus its Combination with Calcipotriol in Mild-to-Moderate Plaque Psoriasis

Abstract

Background:
Plaque psoriasis is a chronic immune-mediated inflammatory disorder that significantly affects quality of life. Combination topical therapy may improve treatment outcomes compared to corticosteroid monotherapy. This study compared the short-term efficacy and safety of topical clobetasol alone versus clobetasol combined with calcipotriol.

Methods:
This observational cross-sectional study was conducted over six months at Narayan Medical College and Hospital, Bihar, India. Sixty adults with mild-to-moderate plaque psoriasis were equally divided into Group A (clobetasol 0.05%) and Group B (clobetasol 0.05% + calcipotriol 0.005%). Treatments were applied once daily for three weeks and on alternate days for the next three weeks. Efficacy was assessed using PASI, PGA, and DSS scores at baseline, week 3, and week 6. Statistical analysis included an unpaired t-test, Fisher’s exact test, and Cohen’s d effect size.

Results:
Both groups were comparable at baseline. Group B demonstrated significantly greater PASI reduction at week 3 (p=0.0140) and week 6 (p=0.0067). PGA scores were significantly lower in Group B at week 6 (p=0.0002). DSS reduction was greater in the combination group, but not statistically significant. Adverse effects were mild and comparable between groups.

Conclusion:
Combination therapy of clobetasol with calcipotriol demonstrated superior short-term efficacy compared to clobetasol alone without increased adverse effects.

Recommendation:
Combination therapy may be considered a preferred short-term treatment option in mild-to-moderate plaque psoriasis to achieve faster and greater clinical improvement.