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Clinical experience with calcipotriene has shown its efficacy in the treatment of psoriasis, both alone1-5and in combination with other agents. This double-blind, placebo-controlled study was designed to provide clinical experience in the United States with once-daily treatment of plaque-type psoriasis with 0.005% calcipotriene ointment. Patients and Methods. Two hundred thirty-five otherwise healthy nonpregnant patients, aged 18 to 86 years (mean, 45.1 years), with stable plaque-type psoriasis covering 5% to 20% of skin surface and showing plaque elevation of at least 4 on a 9-point scale, were entered into a randomized, double-blind, clinical trial of 0.005% calcipotriene ointment applied once a day for 8 weeks. Scaling, erythema, plaque elevation, and physician's global assessment were scored on a 9-point scale. Patients were evaluated at baseline and at weeks 1, 2, 4, 6, and 8 of treatment (Figure 1). Results. Forty percent of patients treated with the active drug and 2.2%

REPORT OF A CASE A 53-year-old woman with Down's syndrome was referred from a nursing home for evaluation of a severe diffuse rash. She had lived in the same institution for nine years. She had a seven-year history of a nonspecific dermatitis and dry skin. Four months previously, she had been treated with lindane lotion on two occasions with minimal benefit. Subsequently, betamethasone diproprionate was applied to the hands and elbows regularly with some improvement until one month previously, when her dermatitis worsened. One week prior to evaluation, a lotion containing triamcinolone acetonide was applied for two days. On the third day her hands became red and swollen. Heavy crusts formed "overnight" on the swollen areas. She developed a diffuse erythroderma within a few days. Allergic contact dermatitis was suspected, and the steroid lotion therapy was discontinued. At the time of our evaluation, her treatment consisted of clear water compresses