ABSTRACT
Introduction: Topical corticosteroids, available in an array of vehicles are used to control a variety of inflammatory skin diseases. Patients preferences for different vehicles may affect their willingness to use treatment. We assess corticosteroid vehicle preference and potential impact of topical characteristics on adherence and quality of life in patients with psoriasis.Methods: Subjects with psoriasis were recruited from Wake Forest University Dermatology Clinic. Subjects sampled desoximetasone 0.25% spray, betamethasone valerate 0.1% cream, triamcinolone acetonide 0.1% ointment, fluocinonide 0.05% gel, betamethasone valerate 0.1% lotion, clobetasol propionate 0.05% foam, and fluocinonide 0.05% solution in a predetermined randomized order. Subjects completed a Vehicle Preference Measure, Determinants of Adherence Measure, and a Determinants of Quality of Life Measure.Results: Patients preferences for the various products were highly variable. Regarding Determinants of Adherence, patients perception of absorption of the medication was ranked as 'quite important/extremely important' by 85% of total subjects. A majority of patients rated medication side effects as 'quite important/extremely important' when asked to consider topical characteristics effect on quality of life.Discussion: There was wide variation in patient preference for topical medication vehicles used for treating psoriasis. Several vehicle characteristics were considered important to adherence. Given the marked variation in vehicle preference, topical treatment should be individualized according to patients preferences.
Subject(s)
Glucocorticoids/therapeutic use , Pharmaceutical Vehicles/chemistry , Psoriasis/drug therapy , Administration, Topical , Betamethasone Valerate/adverse effects , Betamethasone Valerate/chemistry , Betamethasone Valerate/therapeutic use , Clobetasol/adverse effects , Clobetasol/chemistry , Clobetasol/therapeutic use , Desoximetasone/adverse effects , Desoximetasone/chemistry , Desoximetasone/therapeutic use , Drug Compounding , Female , Fluocinonide/adverse effects , Fluocinonide/therapeutic use , Glucocorticoids/adverse effects , Glucocorticoids/chemistry , Humans , Male , Middle Aged , Patient Preference/psychology , Psoriasis/pathology , Quality of LifeABSTRACT
Differences in cutaneous diseases in people of color call for nuanced evaluation and management. One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with consistently successful treatments to meet the needs of the increasingly diverse population served. This review focuses on facial hyperpigmentation and outlines the most common skin disorders and treatment options.