ABSTRACT
BACKGROUND: Psoriasis is a chronic relapsing skin disorder that affects about 2% of the U.S. population and involves the scalp approximately 50% of the time. Topical corticosteroids, including betamethasone valerate, have been used effectively in the treatment of corticosteroid-responsive dermatoses of the skin and scalp. Betamethasone valerate (BMV) in foam vehicle (Luxiq) is designed to improve patient compliance with topical therapy. Superior efficacy over a BMV lotion preparation has been demonstrated with twice-daily use. Even greater compliance would be expected if the drug is effective with once-daily application. PURPOSE: To compare the efficacy of the betamethasone valerate foam (Luxiq) in the treatment of scalp psoriasis following once-daily versus twice-daily dosing. METHODS: Seventy-nine patients with moderate to severe scalp psoriasis from seven centers were enrolled and treated with BMV foam either once a day or twice a day for four weeks. The physician-grader was blinded to the treatment regimen, and the subjects were randomly assigned to either once-daily or twice-daily dosing in a 1:1 ratio. RESULTS: The signs of psoriasis (plaque thickness, scaling, and erythema) were assessed before and after treatment. The investigator's and the patients' global assessments were also evaluated. The composite score improved from 7.7 +/- 2.1 to 3.0 +/- 2.2 with twice-a-day use and from 8.1 +/- 2.2 to 3.9 +/- 2.8 with once-daily use (p > 0.05 for the difference between groups). DISCUSSION: BMV foam is effective for scalp psoriasis with both once-a-day and twice-a-day use. This feature of the BMV foam is encouraging for expected improvement in clinical use.
Subject(s)
Anti-Inflammatory Agents/administration & dosage , Betamethasone/administration & dosage , Psoriasis/drug therapy , Scalp Dermatoses/drug therapy , Administration, Topical , Adolescent , Adult , Aged , Aged, 80 and over , Female , Glucocorticoids , Humans , Male , Middle Aged , Single-Blind MethodABSTRACT
Cutaneous myiasis is the infestation of tissue by the larvae of flies. There are many causes and they are geographically dependent. The clinical presentation is variable depending on the cause and the body part(s) affected, which can include skin, nasal, ocular, oral, aural, gastrointestinal, and genitourinary tracts. Treatment is complete removal of the larvae from the affected site. The ultimate goal is prevention. We briefly review a case report and then review definition, causes, clinical presentation, differential diagnosis, treatment, and prevention. Cutaneous myiasis reiterates the basics of clinical medicine, which require one to obtain a thorough history, including travel, potential risk exposure, and occupation, and to perform a complete physical examination of a patient with any suspicious lesion.
Subject(s)
Myiasis , Aged , Central America , Diagnosis, Differential , Humans , Male , Myiasis/diagnosis , Myiasis/prevention & control , Myiasis/therapy , TravelABSTRACT
We have described briefly a variety of cutaneous infections seen commonly but not exclusively in blacks. Some disorders are prevalent in blacks because of geography (high temperatures, humidity), environment, and low socioeconomic status causing over-crowding, malnutrition, and poor or delayed access to medical care. Only a few occur as a result of the unique way black hair or skin responds to trauma or infection. Physicians managing black patients with dermatologic problems should be aware of and must consider all the factors that initiate, aggravate, and perpetuate cutaneous responses under these conditions.
