The right dose in the right place: an overview of current prescription, instruction and application modalities for topical psoriasis treatments.
BACKGROUND
Compared to treatment success with oral medications, treatment success with topical treatments is currently difficult to achieve.


OBJECTIVE
To assess and compare existing methods of lesion size evaluation, prescription habits, instruction and application modalities of topical medications.


METHODS
Review of current and new procedures to estimate the body surface area, to calculate the most adequate quantity of medication to be prescribed, to instruct patients and to assess the individual dosing procedures of topical treatments.


RESULTS
The most accurate method to assess the body surface area remains the rule of nine, allowing, together with a recently developed calculation disc, to estimate the most adequate quantity of topical treatment (here calcitriol 3 g/g ointment) to be prescribed. Precise instructions to the patient are other important elements for the successful treatment of dermatoses. Dosing devices, such as a spatula, may help patients to dose their daily topical treatment, avoiding over- and underdosing of the medication.


CONCLUSIONS
A correct evaluation of the lesions sizes, a precise calculation of the treatments quantity to be prescribed, clear instructions and treatment-specific individual dosing devices may help to achieve higher patient compliance and treatment success.
Savary
J
J
Paris, France. djsavary@wanadoo.fr
Ortonne
J P
JP
Aractingi
S
S
D000287:Administration, Topical; D002117:Calcitriol / Q000009:adverse effects / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D011307:Drug Prescriptions; D004363:Drug Utilization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020714:Maximum Tolerated Dose; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D011565:Psoriasis / Q000175:diagnosis* / Q000188:drug therapy*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
D003879:Dermatologic Agents; D002117:Calcitriol