Coal tar 2% foam in combination with a superpotent corticosteroid foam for plaque psoriasis: case report and clinical implications

Abstract

Psoriasis is a chronic, inflammatory, immune-mediated, multi-system disease that is treated with a variety of medicines, including topical corticosteroids and, historically, coal tar. In this case, the authors evaluated whether combination therapy with coal tar foam 2% and a topical corticosteroid would induce a remission and maintain clearance of plaque-type psoriasis over an eight-week period. A 59-year-old Caucasian woman with plaque psoriasis of her elbows presented to the authors' dermatology clinic and was treated with clobetasol propionate 0.05% emollient foam in combination with coal tar 2% foam twice daily to her elbows for two weeks. After two weeks, the patient was switched to a maintenance regimen of twice-daily coal tar 2% foam during the week and twice-daily application of the corticosteroid on the weekends. The patient exhibited very favorable clearance of her plaque psoriasis on this regimen at her eight-week follow-up visit. In this case, the combination of coal tar 2% foam and clobetasol propionate 0.05% emollient foam twice daily was used effectively to induce remission of localized plaque psoriasis followed by an efficacious maintenance regimen, which incorporated intermittent therapy with both topical agents.

Figures 1A–1D

Patient treated with coal tar 2% foam and clobetasol propionate 0.05% foam both twice daily to both elbows for two weeks followed by coal tar 2% foam twice daily on weekdays (Monday through Friday) and clobetasol 0.05% emollient foam twice daily on weekends (Saturday and Sunday). 1A. Top left: Left elbow at Baseline; 1B. Top right: Left elbow at Week 8.; 1C. Bottom left: Right elbow at Baseline; 1D. Bottom right: Right elbow at Week 8.