The use and abuse of 0.05 per cent clobetasol propionate in dermatology

In conclusion, there can be no doubt that CP is a remarkable local steroid with potency greater than anything previously available to the dermatologist. It may be useful for short-term (less than 2 weeks) and intermittent treatment of widespread inflammatory dermatoses. It is excellent for treating some stubborn localized inflammatory dermatoses before moving on to more dilute preparations. When prescribing CP, it is important to warn the patient of common side effects, such as atrophy and striae, and to instruct the patient carefully in its use, mentioning body areas that should be spared its application. CP should not be applied to flexural, scrotal, or, with a few exceptions such as discoid lupus erythematosus and actinic reticuloid, facial skin. Its use is contraindicated in infants, toddlers, and children under 12 years of age. In addition, adult patients must be told never to use more than 50 gm per week (the manufacturer's recommendation). The prescribing physician must monitor and regularly review the amount used per unit time. Treatment with CP beyond 2 weeks is not recommended in the product information on CP listed in the Physicians' Desk Reference (1988). Those few patients taking CP for a long period should be managed as though they are on systemic steroids. Episodes of acute stress, such as surgery and intercurrent infection, should be managed with supplemental, if necessary parenteral, glucocorticoid administration.(ABSTRACT TRUNCATED AT 250 WORDS)