Comparative Study of Efficacy and Safety of Topical 1% Methotrexate Gel and 0.1% Betamethasone Valerate Ointment in Treatment of Palmoplantar Psoriasis Using Iontophoresis
Main Article Content
Abstract
Introduction: Chronic autoimmune skin disorder psoriasis affects patients' quality of life in many ways. Palmoplantar psoriasis, which affects the palms and soles, is difficult to treat because to its thick skin and everyday activity restrictions. To treat palmoplantar psoriasis, this study examines the efficacy and safety of 1% methotrexate gel and 0.1% betamethasone valerate ointment applied using iontophoresis.
Methodology: This study was a randomised controlled trial of 60 palmoplantar psoriasis patients aged 18–65—no methotrexate or betamethasone valerate medication in the past six months and no iontophoresis contraindications. A and B were randomly assigned to receive topical methotrexate gel 1% with iontophoresis or betamethasone valerate 0.1%. The primary outcome was PASI reduction from baseline to week 12. AEs and SAEs were monitored, and blood tests were done at baseline, week 6, and week 12 to determine safety.
Results: There were no significant variations in age, gender, baseline PASI and DLQI scores, or psoriasis duration between groups. Group A had a more significant PASI score drop (50% ± 12%) than Group B (40% ± 15%) (p=0.02). DLQI improvement was higher in Group A (45% ± 10%) compared to Group B (35% ± 13%) (p=0.03). Group A had statistically significant improvements in patient-reported symptoms (itching, pain, redness). The most prevalent adverse event was mild skin irritation.
Conclusion: This study found that methotrexate gel 1% delivered via iontophoresis reduced PASI scores, improved DLQI scores, and relieved itching, pain, and redness in palmoplantar psoriasis patients more than betamethasone valerate 0.1%. No significant side effects were reported with any medication. These results imply that topical methotrexate gel 1% with iontophoresis is more effective and safer than topical betamethasone valerate 0.1% for palmoplantar psoriasis.