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Abstract：
BACKGROUND: Chronic plaque psoriasis is the most common type of psoriasis and is characterized by redness, thickness, and scaling. First-line management is with topical treatments.
OBJECTIVE: We sought to undertake a Cochrane review of topical treatments for chronic plaque psoriasis.
METHODS: We systematically searched major databases for randomized controlled trials. Trials reported improvement using a range of related measures; standardized, pooled findings were translated onto a 6-point improvement scale.
RESULTS: The review included 177 randomized controlled trials with 34,808 participants, including 26 trials of scalp psoriasis and 6 trials of inverse and/or facial psoriasis. Typical trial duration was 3 to 8 weeks. When compared with placebo (emollient base), the average improvement for vitamin-D analogues and potent corticosteroids was approximately 1 point, dithranol 1.2 points, very potent corticosteroids 1.8 points, and combined vitamin-D analogue plus steroid 1.4 points once daily and 2.2 points twice daily. However, these are indicative benefits drawn from heterogeneous trial findings. Corticosteroids were more effective than vitamin D for treating psoriasis of the scalp. For both body and scalp psoriasis, potent corticosteroids were less likely than vitamin D to cause skin irritation.
CONCLUSIONS: Reporting of benefits, adverse effects, and safety assessment methods was often inadequate. In many comparisons, heterogeneity made the size of treatment benefit uncertain.
CONCLUSIONS: Corticosteroids are as effective as vitamin-D analogues and cause less skin irritation. However, further research is needed to inform long-term maintenance treatment and provide appropriate safety data.
OBJECTIVE: We sought to undertake a Cochrane review of topical treatments for chronic plaque psoriasis.
METHODS: We systematically searched major databases for randomized controlled trials. Trials reported improvement using a range of related measures; standardized, pooled findings were translated onto a 6-point improvement scale.
RESULTS: The review included 177 randomized controlled trials with 34,808 participants, including 26 trials of scalp psoriasis and 6 trials of inverse and/or facial psoriasis. Typical trial duration was 3 to 8 weeks. When compared with placebo (emollient base), the average improvement for vitamin-D analogues and potent corticosteroids was approximately 1 point, dithranol 1.2 points, very potent corticosteroids 1.8 points, and combined vitamin-D analogue plus steroid 1.4 points once daily and 2.2 points twice daily. However, these are indicative benefits drawn from heterogeneous trial findings. Corticosteroids were more effective than vitamin D for treating psoriasis of the scalp. For both body and scalp psoriasis, potent corticosteroids were less likely than vitamin D to cause skin irritation.
CONCLUSIONS: Reporting of benefits, adverse effects, and safety assessment methods was often inadequate. In many comparisons, heterogeneity made the size of treatment benefit uncertain.
CONCLUSIONS: Corticosteroids are as effective as vitamin-D analogues and cause less skin irritation. However, further research is needed to inform long-term maintenance treatment and provide appropriate safety data.
摘要：
背景：慢性斑块状银屑病是最常见的银屑病类型，其特征是发红，厚度,和缩放。一线管理是局部治疗。
目的：我们试图对慢性斑块状银屑病的局部治疗进行Cochrane综述。
方法：我们系统地检索了主要数据库中的随机对照试验。试验报告使用一系列相关措施有所改善；标准化，汇总的结果被转化为6分改善量表.
结果：该综述包括177项随机对照试验，包括34,808名参与者，包括26项头皮牛皮癣试验和6项反向和/或面部牛皮癣试验。典型的试验持续时间为3至8周。与安慰剂（润肤剂）相比，维生素D类似物和强效皮质类固醇的平均改善约为1分，地替洛尔1.2分，非常有效的皮质类固醇1.8点，联合维生素D类似物加类固醇1.4分每日一次和2.2分每日两次。然而,这些是来自异质性试验结果的指示性获益.皮质类固醇在治疗头皮牛皮癣方面比维生素D更有效。对于身体和头皮牛皮癣，强效皮质类固醇比维生素D更不可能引起皮肤刺激.
结论：福利报告，不利影响，和安全评估方法往往是不够的。在许多比较中，异质性使得治疗获益的大小不确定。
结论：皮质类固醇与维生素D类似物一样有效，并且对皮肤的刺激性较小。然而,需要进一步研究以告知长期维持治疗并提供适当的安全性数据.
目的：我们试图对慢性斑块状银屑病的局部治疗进行Cochrane综述。
方法：我们系统地检索了主要数据库中的随机对照试验。试验报告使用一系列相关措施有所改善；标准化，汇总的结果被转化为6分改善量表.
结果：该综述包括177项随机对照试验，包括34,808名参与者，包括26项头皮牛皮癣试验和6项反向和/或面部牛皮癣试验。典型的试验持续时间为3至8周。与安慰剂（润肤剂）相比，维生素D类似物和强效皮质类固醇的平均改善约为1分，地替洛尔1.2分，非常有效的皮质类固醇1.8点，联合维生素D类似物加类固醇1.4分每日一次和2.2分每日两次。然而,这些是来自异质性试验结果的指示性获益.皮质类固醇在治疗头皮牛皮癣方面比维生素D更有效。对于身体和头皮牛皮癣，强效皮质类固醇比维生素D更不可能引起皮肤刺激.
结论：福利报告，不利影响，和安全评估方法往往是不够的。在许多比较中，异质性使得治疗获益的大小不确定。
结论：皮质类固醇与维生素D类似物一样有效，并且对皮肤的刺激性较小。然而,需要进一步研究以告知长期维持治疗并提供适当的安全性数据.
