Intermittent maintenance therapy in chronic hand eczema with clobetasol propionate and flupredniden acetate

The clinical effect of two topical corticosteroids, one of very strong potency (clobetasol propionate), and one of medium potency (flupredniden acetate), was studied in the maintenance therapy of 55 patients with chronic hand eczema. Initially, 61 patients were treated on both hands continuously for 1 to 3 weeks with clobetasol only which brought about healing in 90% of cases (mean time to healing: 11 days). In a subsequent double-blind left/right study, the capacity of the two corticosteroids for keeping the dermatitis in remission was compared using an intermittent schedule of 2 applications a week. The protocol was followed by 46 patients and the mean observation period was 138 days. Treatment with clobetasol kept patients free from relapses during the entire observation period in 70%, with flupredniden in 30%. Relapses occurred with clobetasol after a mean of 66 days, with flupredniden after 36 days. Side-effects, occurring with similar frequency with both drugs, were few and mild. It is suggested that an intermittent schedule is advantageous when using a corticosteroid of high potency.