Eczema Light Therapy

This is useful in cases of stubborn, chronic atopic dermatitis. UVB combined with emollients and tar have certainly been helpful. UVB is not suitable for acute exacerbations. It appears that a combination of UVA as well as UVB is better than UVB alone. PUVA (psoralens + UVA) appears more effective than UVB. There is the problem of rebound effect after discontinuing PUVA and the increased risk of skin cancer is documented.

Narrow Band UVB

311 nanometers has been useful although further work needs to be done. A report on 5 patients with severe atopic eczema shows efficacy in all patients with a cumulative dose of 9.2 J/cm2 Benefit was seen after 3 weeks.
J Am Acad Dermatol 1999;40:995-7

PUVA

This involves a combination of an oral photosensitizing drug psoralen combined with UVA. This has been shown to be effective in children resulting in clearance or near clearance.
Br J Dermatol 1988;118:791-5
Br J Dermatol 1993;129:431-6

Cutivate^® (Fluticasone propionate)

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INTRODUCTION
A synthetic fluorinated corticosteroid recently introduced to Canada but has been available in the U.S market for a number of years. Fluticasone propionate is classified as a medium potency topical corticosteroid... | Read more ...

CLININCAL EXPERIENCE
Topical corticosteroids are extensively used. Atopic eczema will be used as a model for discussing this new topical corticosteroid. A concern with the use of any long term medication is the potential for... | Read more ...

INDICATIONS
Used for all inflammatory and pruritic conditions that are corticosteroid responsive e.g. eczema, psoriasis and dermatitis. It should not be used in rosacea, acne, or perioral dermatitis... Read more ...

PATIENT PROFILE
4 double blind randomized controlled studies in 772 adults and children showed the once the acute episode of moderate to severe eczema had been treated effectively that twice weekly... | Read more ...

DOSING
For the acute stage of eczema daily application of Cutivate is recommended. New evidence guides us to apply Cutivate twice a week to maintain control of eczema... | Read more ...

EFFICACY
Although not indicated for use on children in Canada, studies have shown that once daily application is safe and effective in children with atopic eczema... | Read more ...

COMPLIANCE
Daily application in the acute phase and thereafter twice weekly maintaince should help with compliance ... | Read more ...

SIDE EFFECTS, SAFETY AND RISKS
Approx 270 million packs sold since 1990 in US ... | Read more ...

COST OF TREATMENT
Cost of this drug is in line with other potent topical corticosteroids. Cost effectiveness is seen if effective clinical response is realized. The utilization of a twice a week regimen significantly reduces costs... | Read more ...

View the entire Cutivate® (Fluticasone propionate) presentation.

Eczema Light Therapy

Phototherapy

Narrow Band UVB

PUVA