Bilateral Comparison of Liquid Paraf(cid:976)in and Cream Base on
Transepidermal Water Loss among Psoriasis Patients:
A Randomized Trial
Chutima Churee MSc1, Sukhum Jiamton MD, PhD2, Kamol Udol MD, MSc3, Walaiorn Pratchyapruit MD4
Affiliation :
1 Department of Photobiology, Institute of Dermatology, Bangkok, Thailand
2 Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
3 Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
4 Department of Bioengineering, Institute of Dermatology, Bangkok, Thailand
Background : Psoriasis is a common chronic in(cid:976)lammatory disease. Psoriasis lesions have water-holding and show increased
transepidermal water loss (TEWL). Patients experience pain, discomfort, and skin dryness or dehydration. Skin moisturizing is a
major component of treatment for these patients to maintain the smoothness of the skin and to break the dry-skin cycle.
Objective : To compare the skin moisturizing ef(cid:976)icacy of liquid paraf(cid:976)in (LP) with cream base (CB) on TEWL and skin hydration on
normal and psoriasis lesions of psoriasis patients.
Materials and Methods : The present study was conducted among 100 participants with Psoriasis Area and Severity Index (PASI)
score less than 10. Participants aged 18 years or older who visited the Outpatient Department of Institute of Dermatology were
randomly selected to have the substances applied on normal skin and psoriasis lesions twice daily with LP on one side and CB on
the other side. TEWL and skin hydration were measured at baseline and after application at the end of the fourth week.
Results : There were 48 females and 52 males, with the mean (SD) age of 45 (13) years and average duration of psoriasis of 12
years. For normal skin, TEWL at the end of 4-week treatment period signi(cid:976)icantly decreased in areas applied with LP compared
to CB (median change from baseline -0.30 g/m²/hour versus 0.30 g/m²/hour, respectively, p=0.01). For psoriasis lesions, change
of TEWL was not different between the two agents (p=0.22). Regarding skin hydration after four weeks of treatment, there was
no statistically signi(cid:976)icant difference between LP and CB in normal skin (change from baseline of 5.04 AU for LP and 4.20 AU for
CB). For psoriasis lesions, skin hydration increased more signi(cid:976)icant with CB than with LP (change from baseline 4.00 AU for CB
versus 2.65 AU for LP, p<0.01).
Conclusion : For the patients with plaque type psoriasis, LP reduced TEWL more than CB in normal skin, but CB increased skin
hydration more than LP in psoriasis lesions.
Keywords : Psoriasis, Transepidermal water loss, Skin hydration
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