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May 25, 1970

Extemporaneous vs Commercial Formulations of Steroids for Topical Usage

Author Affiliations

Palo Alto, Calif

JAMA. 1970;212(8):1380. doi:10.1001/jama.1970.03170210084031

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To the Editor.—  There seems to be some misunderstanding on the part of Dr. Epstein.Our purpose in this article was to suggest that physicians employing extemporaneous prescriptions of corticosteroids should evaluate them and determine if they had significant activity over the vehicle. While there were many published examples we could have used, we selected this particular one for two reasons. It was suggested by an outstanding dermatologist, and was published in a widely distributed journal. The six identical prescriptions were written as directed in that publication. (Editorial requirements of The Journal did not permit us to reproduce this prescription exactly as it was written). A specific base was directed but the resulting medications hardly reflected this. Even with these unplanned variations there was no vasoconstrictor activity in any preparation. Further, we repeatedly draw attention to the fact that this prescription calls for triamcinolone "powder" from crushed tablets and that