To the Editor.—
In the article by Dr. Baden,1 a sequential treatment is described for hyperkeratotic dermatitis of the palms using a keratolytic gel and corticosteroid ointment. The gel (Keralyt) contains 60% propylene glycol and 19.4% ethyl alcohol with 6% salicylic acid. Propylene glycol in water under occlusion is effective in the treatment of the ichthyoses.2 A 0.05% fluocinonide gel (Topsyn) has 95% propylene glycol and 5% water at a pH of 4.5.By adding 6% salicylic acid to Topsyn, I attempted to formulate a keratolytic gel (propylene glycol in water) with a corticosteroid (fluocinonide) in a single preparation, thus obviating the need for sequential therapy. Through the use of overnight occlusion over this preparation, two patients have obtained considerable improvement of chronic palmar hyperkeratotic eczematous dermatitis in two weeks.
Rosenberg FW. Hyperkeratotic Dermatitis of the Palms. Arch Dermatol. 1975;111(8):1069. doi:10.1001/archderm.1975.01630200129016