Comparison of efficacy and safety of topical glyceryl trinitrate vs. oral nifedipine in idiopathic perniosis: results of a randomized clinical trial

Objective: to compare the therapeutic efficacy and safety of topical vasodilator glyceryl trinitrate (gtn) 0.4% cream, with systemic nifedipine (10-40mg/day) in patients with idiopathic perniosis (ip). methods: patients with ip (n=65) were randomized into group a receiving gtn 0.4% cream (n=31) or group b receiving oral nifedipine, 10-40mg/day (n=34). they were evaluated for improvement in signs and symptoms and any side effects, every 15 days for six weeks. primary outcome was efficacy and secondary outcome was side effects. results: 53 patients completed the study protocol. twenty-three out of 26 (88%) patients in group a whereas 21 out of 27 (77%) in group b had complete clearance of lesions in six weeks (p=0.52). clearance of lesions was achieved earlier (10.9 ±6 days) in group b as compared to (16.6±11.5 days) group a (p=0.05). conclusion: gtn 0.4% cream is an effective and safe alternative to oral nifedipine in the treatment of ip. oral nifedipine leads to clearance of lesions earlier than gtn cream.