TherapyLimited application of fluticasone propionate ointment, 0.005% in patients with psoriasis of the face and intertriginous areas☆,☆☆,★,★★
Section snippets
Methods
This open-label study recruited adults with moderate to severe psoriasis (N = 20) involving the face or intertriginous areas and nonfacial, nonintertriginous areas. Patients were required to be at least 18 years of age and in good general health. Disease must have been present for at least 1 year and must have been stable or worsening for more than 1 week before the study. Lesions suitable for evaluating the response to treatment had to be present. Those excluded from enrollment included
Results
Twenty patients were enrolled into the study. Patient demographics are presented in Table I.
Characteristic (N = 20) Age (y), mean (range) 53 (28-79) Ethnicity (%) Black 10 White 60 Hispanic 30 Female/male (%) 40/60
Discussion
Few studies have examined the safety and efficacy of topical corticosteroids on facial and intertriginous skin, and even fewer data are available on long-term treatment of these sites. Therefore in chronic disease it is necessary to develop safe regimens in which improvement is achieved without incurring the side effects of cutaneous atrophy. In the present study, fluticasone propionate ointment 0.005% was applied twice daily for 2 weeks of acute treatment. This acute treatment phase was
References (13)
Structure-activity relationships of topically active steroids: the selection of fluticasone propionate
Respir Med
(1990)The human pharmacology of fluticasone propionate
Respir Med
(1990)- et al.
Corticosteroids
- et al.
Glaucoma induced by application of corticosteroids to the periorbital region
Arch Dermatol
(1978) Fluticasone propionate: safety profile
Cutis
(1996)- et al.
Efficacy and safety of treatment with fluticasone propionate ointment in the acute and maintenance treatment of moderate to severe atopic dermatitis [abstract]
J Eur Acad Dermatol Venereol
(1996)
Cited by (57)
Exploring the therapeutic potential of functional excipient-based nanoemulgel of fluticasone propionate for the management of psoriasis
2023, Journal of Drug Delivery Science and TechnologyClinical trials and future perspectives of antiinflammatory agents
2023, Recent Developments in Anti-Inflammatory TherapySafe use of topical medications. I: Corticosteroids
2022, FMC Formacion Medica Continuada en Atencion PrimariaCrisaborole 2% ointment for the treatment of intertriginous, anogenital, and facial psoriasis: A double-blind, randomized, vehicle-controlled trial
2020, Journal of the American Academy of DermatologyCitation Excerpt :Multiple factors should be considered when selecting therapies for psoriasis.13,14 Historically, facial and intertriginous skin has responded similarly to both topical steroids and nonsteroidals.8,9,15,16 Current topical therapeutic options include topical corticosteroids, calcineurin inhibitors, retinoids, vitamin D analogues, and various combinations of these agents.
Psoriasis inversa: A separate identity or a variant of psoriasis vulgaris?
2015, Clinics in DermatologyCitation Excerpt :The inverse areas are considered more sensitive and prone to side effects from topical steroids (ie, due to thinner skin at these locations).28 Treatment with steroids should probably be done with caution to avoid side effects; however, no data comparing steroid side effects in inverse and extensor sites have confirmed a higher rate of corticosteroid-induced implications.29 The thinner skin and lack of scaling of the psoriatic lesions at the intertriginous areas can also assist in the treatment.
Treatment of intertriginous psoriasis: From the Medical Board of the National Psoriasis Foundation
2009, Journal of the American Academy of DermatologyCitation Excerpt :This taper or stopping of therapy will minimize the possibility of tachyphylaxis or side effects such as atrophy, telangiectasia, striae, and ulceration. Options for continued therapy after the initial 2 to 4 weeks include switching to one of the other first-line agents, calcipotriene (calcipotriol), pimecrolimus, or tacrolimus; using the low-potency topical steroid product one or two times per week for maintenance15; or a combination of these approaches. Higher-potency topical steroid products are also effective but have a higher incidence of side effects because efficacy and side effects are directly correlated.
- ☆
Supported in part by a grant from Glaxo Wellcome.
- ☆☆
*Dr Lebwohl has served as an investigator and consultant for Glaxo Wellcome.
- ★
Reprint requests: Mark G. Lebwohl, MD, The Mount Sinai School of Medicine, Department of Dermatology, One Gustave L. Levy Place, New York, NY 10029.
- ★★
J Am Acad Dermatol 2001;44:77-82.