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Patients and treatment The study comprised 44 adult patients with scalp psoriasis. Patients using oral as well as topical medications known to a¡ect psoriasis were excluded. Furthermore, patients receiving local treatment known to a¡ect psoriasis within 2 weeks and taking oral medications within 4 weeks of the study commencing were excluded. Although the patients were randomly allocated a group (A or B), the evaluator knew what treatment had been given. To remove scales the patients were pretreated before entering the study. Salicylic acid in oil was massaged into the scalp and left in place overnight. The next morning the material was removed using a tar shampoo. The 22 patients in group A were treated with a dermalight 80 psoracomb (Dr. R. HÎnle, Munich, Germany) equipped with two UVB tubes, and the 22 patients in group B were treated with betamethasone valerate solution. The maximum emission spectrum for the UVB tubes was 310 ^ 315 nm; the irradiance being 2.5 mW/cm2 at a distance of 30 cm. The comb, however, was moved through the hair at a distance of 5 cm from the UVB tubes to the scalp. Although the hair was separated, the high concentration of UVB in the emission spectrumwas considered necessary to overcome the protective shield of the hair. Treatments were given once a day (5 days/week) to both groups for a total of 3 weeks, i.e. 15 times with either UVB (group A) or betamethasone valerate solution (group B). The patients in group A were initially irradiated with 0.20 (0.13 ^ 0.27) J/cm2 UVB in order to assess their skin type. If no discomfort occurred, the dose was gradually increased by 0.23 J/cm2 per day to an upper limit of 1.36 (0.72 ^ 1.72) J/cm2 UVB per treatment, otherwise the initial dose was continued for another 2 days. Evaluation The scalp psoriasis was graded using a score system taking into consideration erythema, in¢ltration and scaling (PASI score). The response was classi¢ed as ``improved'' when more than 50% of the lesions had disappeared, otherwise the designation ``unchanged/worse'' was used. Relapses were likewise de¢ned as when more than 50% of the lesions had recurred. The patients were recalled 2 weeks after the end of the treatment for a follow-up evaluation.

Comparison of Betamethasone Valerate Solution with Phototherapy (UVB Comb) in Scalp Psoriasis Treatment