Limited application of fluticasone propionate ointment, 0.005% in patientswith psoriasis of the face and intertriginous areas

Background: Facial and intertriginous skin is more susceptible to corticost eroid-induced atrophy. Dosing regimens are needed for long-term management of corticosteroid-sensitive sites. Objective: The safety and efficacy of 0.005% fluticasone propionate ointmen t were assessed in the short- and long-term management of moderate to sever e psoriasis of facial and intertriginous areas compared with nonfacial, non intertriginous areas. Methods: Affected areas in 20 patients with psoriasis were treated twice da ily for 2 weeks, then once daily for 2 consecutive days every week for 8 mo re weeks. Results: More than 50% improvement occurred after 2 weeks (day 15) in 100% of facial and intertriginous lesions and was maintained during long-term th erapy in more than 85% of facial and intertriginous lesions. More than 50% improvement for nonfacial, nonintertriginous areas reached only 80% by day 15. Recurrence rates for facial and intertriginous areas were lower than in the nonfacial, nonintertriginous areas. Skin atrophy and telangiectasia di d not occur. Facial and intertriginous sites responded more quickly to topi cal fluticasone propionate ointment than nonfacial, nonintertriginous skin. Conclusion: Limited application of fluticasone propionate ointment over a p eriod of 10 weeks is effective and delays lesion recurrence without causing skin atrophy in patients with moderate to severe psoriasis in areas at ris k for corticosteroid application, such as facial and intertriginous areas.