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February 1995

Occlusion of Potent Topical Steroids

Author Affiliations

Division of Dermatology Baylor University Medical Center 3500 Gaston Ave Dallas, TX 75246

Arch Dermatol. 1995;131(2):226-227. doi:10.1001/archderm.1995.01690140112023

The use of potent topical corticosteroids in the treatment of erythrodermic psoriasis is fraught with difficulties and complications. The report of Arbiser et al1 in the June 1994 ''Cutting Edge'' should be viewed with caution in the light of large, previously published series that have not been referenced.2,3 In these articles, the use of systemic or potent topical steroids was shown to be the most common trigger factor for erythrodermic psoriasis. There is no doubt that the use of potent topical steroids under occlusion, even in the shortterm as advocated by Arbiser et al, may give temporary relief but should not be considered the treatment of choice due to the potential for ''rebound.'' Of interest is that their first patient (''poorly compliant'') has had subsequent hospital admissions for his psoriasis following the course of treatment prescribed.

An erythrodermic protocol using cool baths, wet dressings, and low-potency topical steroids

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