Sunday, June 17, 2012

Your question answered by Dr Sandeep Kumar Consultant Dermatologist at Mater Health Service Redland



" I have a 45yo with psoriasis on the scalp, face and elbow without any systemic symptoms. He is relative well otherwise. How would you treat this?" GP Qld

"If there are no contraindications, can use Daivobet gel nocte on scalp and taper down treatment as needed. Can use Daivobet ointment daily on other areas. Tar shampoo twice a week may help."



Dr Sandeep Kumar
Consultant Dermatologist
Mater Health Centre Redland
16 Weippin Street
Cleveland Qld 4163
Phone 07 3281 4111

5 comments:

  1. What treatment would you offer a 45 year old female with chronic inverse psoriasis of the groin area, exacerbated by high summer temps and sweat? Pt. is otherwise very well.

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    Replies
    1. I have emailed your question to Dr Sandeep Kumar. Admin@gpexamsupport.com.au

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    2. 1% LPC in BOZ cream bd
      Hydroform Cream bd when bad

      Dr Sandeep Kumar

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    3. As most of us may not know what 1% LPC in BOZ cream and Hydroform cream are, I have asked Mr Tien Chuc one of our Compounding Pharmacists to comment and clarify this further.

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    4. 1) Coal tar preparations has long been employed in the treatment of psoriasis. There is a synergistic effect when used with ultraviolet light treatment. It continues to be one of the agents of first choice in the treatment of psoriasis. It is particularly suited to the treatment of stable chronic plaque psoriasis. Its mode of action is unknown but after an initial transient increase in epidermal proliferation it can produce a reduction in the thickness of viable epidermis.

      LPC (liquor picis carbonis) is essentially 20% coal tar in an ethanol base solution. LPC can be compounded into many bases, including sorbolene or aqueous cream base or BOZ ointment (BOZ = boric acid, olive oil in zinc ointment).
      LPC is usually written in strengths of 1-3% creams or ointments.
      (NOTE: LPC 1% is not the same as coal tar 1%. Raw coal tar preparations are seldom used, therefore not commonly available).
      LPC preparations tends to be a light/moderate brownish yellow colour; these preparations can stain some clothing.
      LPC 1% in BOZ is a thick preparation with some occlusive properties. If using another cream concurrently, BOZ based preparations are best applied afterwards (about 10-20 minutes afterwards if time permits).


      2) Hydroform Cream (hydrocortisone 1% combined with clioquinol 1%, an antifungal agent) in a lanolin, paraben, preservatives and fragrances free base. If an antifungal agent is not required, then a hydrocortisone 1% cream (or ointment) is available

      (Tien Chuc - Manly Village Pharmacy)

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