Topical combination therapy with vitamin D3 and corticosteroid ointment for palmoplantar pustulosis: A prospective, randomized, left-right comparison study

Background: Vitamin D-3 ointment and corticosteroid ointment are both used for the treatment of palmoplantar pustulosis (PPP). However, to date there is no systematic study of the efficacy of combination therapy for the treatment of PPP. Objective: We compared the efficacy of a topical combination therapy with vitamin D-3 and a topical corticosteroid with that of topical corticosteroid alone in the treatment of PPP. Method: We evaluated left-right comparison study of the efficacy of a combination therapy consisting of maxacalcitol ointment and betamethasone butyrate propionate ointment (BBP), and monotherapy with BBP alone in 27 patients with PPP for 8weeks. Results: The improvement in the symptom (erythema, pustules/vesicles, hyperkeratosis/scales) scores was high for the combination therapy. In particular, the improvement rate for pustules/vesicles at week 8 after the combination therapy was significantly higher than for the monotherapy (p<0.05). Conclusion: This combination regimen demonstrated that not only topical corticosteroids, but also topical vitamin D-3 ointment, is useful for the treatment of PPP.