Dr. Lyn Guenther is practicing dermatology in London, Ontario, and is the president of Guenther Research Inc. She was the chaired several prominent organizations including the Canadian Society for Dermatologic Surgery. Dr. Guenther is a prolific author, having over 200 publications, and has been the medical editor of Dermatology Times of Canada since 1998, and a longtime contributor to Skin Therapy Letter.
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Mild to moderate atopic dermatitis (AD) is often controlled by behavioral measures such as skincare and avoidance of triggers in addition to topical treatments such as topical corticosteroids (TCS), topical calcineurin inhibitors (TCI), and crisaborole, a phosphodiesterase-4 inhibitor (PDE4-I).
The discussed cases reflect the panels’ real-world clinical experience with crisaborole for the treatment of patients with AD and the off-label treatment of irritant dermatitis.
Medical algorithms are created, yet there is a paucity of information about how such algorithms should be created and the optimal way to develop an excellent algorithm. Well constructed medical algorithms have the potential to improve and standardize medical decisions, enhance adherence to better guidelines and improve patient care.
Fusidic acid/betamethasone 17-valerate cream (Fucibet®) is a cosmetically acceptable, well tolerated cream which is hydrating and improves the TSS dermatitis score in secondarily infected dermatitis. In addition, it clears bacteria in infected dermatitis better than vehicle suggesting that improving the dermatitis with a steroid might be synergistic, perhaps through a reduction in bacterial load.
The scalp is involved in up to 80% of individuals with psoriasis. Topical treatment with corticosteroids with or without vitamin D3 analogues is the mainstay of treatment, but other therapies such as light treatment and systemic drugs including biologics are discussed.
Colloidal oatmeal has been used for centuries in skin care as a soothing agent to relieve itch and irritation. Its use, efficacy, and mechanism of action are discussed.
Biologics plays an important role in treating moderate to severe psoriasis. This article looks at combination treatment with traditional systemics and topicals, and the possible benefits of this approach.
Treatments for Scalp Psoriasis with Emphasis on Calcipotriol Plus Betamethasone Dipropionate Gel (Xamiol®)
Scalp psoriasis occurs in 50%-75% of patients with plaque psoriasis. It may be the only area of the body affected, or it may be associated with disease elsewhere, including psoriatic arthritis. Most cases are treated topically, usually with steroids and/or calcipotriol.
Advancements in topical antipsoriatic therapies have provided safer and more effective treatment options, especially when used in combination. Consequently, much research is underway to investigate novel treatment combinations for psoriasis in the hope that it will provide further enhancements in efficacy.
TCIs have an important place in the therapeutic armamentarium for AD. They are approved as second line agents for individuals >2 years of age, and have a good safety profile when used short-term or intermittently long-term.
Psoriasis, acne vulgaris and photoaging are common conditions. Tazarotene is a pro-drug of tazarotenic acid, a receptor-selective retinoid, which has shown efficacy in the treatment of these disorders. In the treatment of acne vulgaris, it has greater comedolytic activity than the currently available topical retinoids.