Randomized controlled trial and cost-effectiveness analysis: Comparing chlorhexidine scrub, ZnO-nanoparticle socks, and their combination in pitted keratolysis treatment
3
Issued Date
2023-01-01
Resource Type
ISSN
03852407
eISSN
13468138
Scopus ID
2-s2.0-85169075276
Pubmed ID
37475211
Journal Title
Journal of Dermatology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Dermatology (2023)
Suggested Citation
Leeyaphan C., Kulthanachairojana N., Taychakhoonavudh S., Chanyachailert P., Kobkurkul P., Buranaporn P., Yenyuwadee S., Matthapan L., Prasong W., Panyawong C., Bunyaratavej S. Randomized controlled trial and cost-effectiveness analysis: Comparing chlorhexidine scrub, ZnO-nanoparticle socks, and their combination in pitted keratolysis treatment. Journal of Dermatology (2023). doi:10.1111/1346-8138.16903 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/89385
Title
Randomized controlled trial and cost-effectiveness analysis: Comparing chlorhexidine scrub, ZnO-nanoparticle socks, and their combination in pitted keratolysis treatment
Author's Affiliation
Other Contributor(s)
Abstract
A cost-effective treatment for pitted keratolysis (PK) is the use of 4% chlorhexidine scrub. Zinc oxide nanoparticle (ZnO-NP)-coated socks have also shown efficacy in PK prevention. In this study, we aimed to assess the cost-effectiveness and safety of combined 4% chlorhexidine scrub and ZnO-NP-coated sock treatment compared to monotherapy. This randomized, controlled trial included 60 male security guards and hospital porters aged ≥18 with PK. Participants were randomly assigned to one of three treatment groups: 4% chlorhexidine scrub, ZnO-NP-coated socks, or combination therapy. Treatment outcomes were evaluated after 4 weeks. Incremental cost-effectiveness ratios (ICERs) were calculated using cost-utility analysis. The greatest reduction in visual analog scale scores for foot odor was observed in the combination therapy group, but it was nonsignificant (P = 0.186). Clinical improvement was observed across all groups. The cost-utility analysis revealed that chlorhexidine scrub and regular socks were the least expensive options. The placebo and ZnO-NP-coated sock group had an ICER of US $31 082/quality-adjusted life years (QALYs) gain, while the combination therapy gained US $45 105/QALYs compared to the chlorhexidine scrub and regular sock group. Based on our findings, for the treatment of PK, 4% chlorhexidine scrub remains the most cost-effective choice.