A review of topical corticosteroid sprays for the treatment of inflammatory dermatoses

Background: Topical corticosteroids are available in many vehicles. However, patients' preference for vehicles are variable and could be tailored to maximize patient adherence. Spray vehicles may offer, convenience, and strong efficacy. Methods: A literature review was conducted using keywords: clobetasol, desoximetasone, betamethasone, triamcinolone, corticosteroid, topical, spray, vehicles, treatment, and clinical trial. Results: For moderate-to-severe plaque psoriasis, 87% of subjects achieved an Overall Disease Severity (ODS) Score ≤2 at week two and 78% achieved an ODS ≤1 after four weeks with clobetasol propionate (CP) 0.05% spray compared to 17% and 3% in the control group, respectively (P<0.001). For desoximetasone 0.25% spray, 31%-53% with moderate-to-severe psoriasis achieve Physician's Global Assessment (PGA) score ≤1 at day 28 versus 5%-18% in the vehicle spray group (P<0.01). For betamethasone dipropionate 0.05% spray, 19% with mild-to-moderate plaque psoriasis achieved an Investigator's Global Assessment (IGA) score ≤1 or a 2-grade reduction in IGA versus 2.3% in vehicle group (P≤0.001). For mild-to-severe steroid responsive inflammatory dermatoses, 64% using triamcinolone acetonide 0.2% spray achieved clear or almost clear skin at day 14 (no P value reported). Adverse events including burning, irritation, and dryness were similar across all corticosteroids

The dermatology residency application process

The dermatology application process is grueling, that is tough to navigate without the proper guidance. This commentary is meant to shed light on the factors that can help applicants stand out in order to be successful in the match. It includes observations from successful applicants from the most recent match process

The dermatology residency application process

The dermatology application process is grueling, that is tough to navigate without the proper guidance. This commentary is meant to shed light on the factors that can help applicants stand out in order to be successful in the match. It includes observations from successful applicants from the most recent match process

Diet and psoriasis

Background: Patients with psoriasis have a growing interest in managing their disease through diet.Objective: This review paper aims to analyze dietary interventions for psoriasis and their outcome.Methods: Terms "psoriasis AND diet" were used to search PubMed database and 63 articles describing dietary changes influencing psoriasis were selected.Results: Low calorie diet (LCD) improves Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in conjunction with topical or systemic therapy, although LCD was unsuccessful in maintaining disease remission when patients discontinued concomitant cyclosporine or methotrexate therapy. A fish oil diet improved baseline PASI of 7.7 to 5.3 at three months and 2.6 at 6 months compared to control (PASI: 8.9, 7.8, and 7.8, respectively). A randomized, double-blind, placebo-controlled study investigating selenium supplementation in psoriasis provided no PASI improvement. Zinc supplementation with concomitant betamethasone valerate 0.0025% ointment in a randomized, double-blind, placebo-controlled study provided a mean PASI of 11.2 in the intervention group and 8.0 in the control group with no significant difference between both arms. Gluten free diet and vitamin D supplementation were also efficacious dietary changes although results were mixed.Conclusions: Dietary changes alone do not cause a large effect in psoriasis but may become an important adjunct to current first line treatments

Diet and psoriasis

Background: Patients with psoriasis have a growing interest in managing their disease through diet.Objective: This review paper aims to analyze dietary interventions for psoriasis and their outcome.Methods: Terms "psoriasis AND diet" were used to search PubMed database and 63 articles describing dietary changes influencing psoriasis were selected.Results: Low calorie diet (LCD) improves Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in conjunction with topical or systemic therapy, although LCD was unsuccessful in maintaining disease remission when patients discontinued concomitant cyclosporine or methotrexate therapy. A fish oil diet improved baseline PASI of 7.7 to 5.3 at three months and 2.6 at 6 months compared to control (PASI: 8.9, 7.8, and 7.8, respectively). A randomized, double-blind, placebo-controlled study investigating selenium supplementation in psoriasis provided no PASI improvement. Zinc supplementation with concomitant betamethasone valerate 0.0025% ointment in a randomized, double-blind, placebo-controlled study provided a mean PASI of 11.2 in the intervention group and 8.0 in the control group with no significant difference between both arms. Gluten free diet and vitamin D supplementation were also efficacious dietary changes although results were mixed.Conclusions: Dietary changes alone do not cause a large effect in psoriasis but may become an important adjunct to current first line treatments

Hidradenitis Suppurativa and Scrotal Elephantiasis Case Report

© Lippincott Williams & Wilkins. Scrotal elephantiasis occasionally presents in conjunction with hidradenitis suppurativa (HS). A 39-year-old morbidly obese African American man, with a previous smoking history, has a 20-year history of HS complicated by a 3-year history of scrotal elephantiasis. His Hurley Stage III HS affects the scrotum, penis, lower abdomen, bilateral groin, and buttock regions. Although his scrotal edema is likely attributed to his history of HS, other causes were ruled out. A computed tomography scan of pelvis with intravenous contrast revealed edematous enlargement of the scrotum and multiple inflammatory abscesses consistent with HS. His condition was complicated by development of infection of the scrotal, perineal, and penile areas. He is currently on adalimumab 40 mg weekly and uses silvadene 1% cream topically. Improvement of his HS has been attributed to the current medical regimen and weight loss. He is responding well to implemented adalimumab for HS with no adverse effects reported. He has undergone several irrigation and debridement procedures for scrotal elephantiasis with success. He is currently preparing for gastric bypass surgery and lumpectomy after this procedure