BACKGROUND
The keratolytic effect of urea is well-known, although the majority of the available studies rely on clinical observation only. The aim of this open trial was to evaluate, through clinical and ultrasound assessment, the efficacy and tolerability of a 50% urea anhydrous paste on hyperkeratotic psoriatic plaques.
METHODS
Twenty-five patients (12M/13F; age: 35-75 years) with plaque psoriasis characterized by an evident hyperkeratotic component were enrolled. One target lesion was selected in each patient that was instructed to apply a 2 ml standard dose of 50% urea anhydrous paste twice a day for up to 3-week study duration.
RESULTS
Clinical clearance of hyperkeratosis at day 21 was observed in 23 out of 25 plaques (92%), with 9 (36%) and 10 (40%) patients already reaching clear status respectively at day 7 and 14. Ultrasound significant reduction of the mean epidermal thickness score was also observed at the same time-points. No side effective were reported and all patients rated the product as excellent in terms of cosmetic acceptability.
CONCLUSIONS
The tested product resulted to be an effective keratolytic agent in plaque psoriasis. Strength of our study was the ultrasound assessment, allowing to objectively confirm and correlate the epidermal changes seen at clinical evaluation.
