January, '00 | Briefing | Mail | Don't Say This | Articles | Other Places | Archives | Send Mail | Ed Dewke | Legal Stuff
Low-dose Betamethazone For Me
from Lorraine

I have been reading with interest the various mails on Dovonex. I have had P since I was 12 (31 years). When I am using Dovonex I mix it with equal amounts of Lubriderm and have not noticed any decline in its affective properties.

I have had soooooooooooo many different treatments in that time. A low dose betamethazone works best for me, but in a flare up, I use Dovonex until I have the lesions under control then switch back to betamethazone. When I lived in England they also had a liquid form of betamethazone that was wonderful for scalp applications, but this is too expensive here.

Diprolene burned my skin. Methotrexate made me feel sick most of the time, so gave that up after a year. I have only been completely clear once in my life—a vacation in Spain did the trick. But within 3 weeks of returning to England, the lesions were back. A trip to Cyprus did not have the same affect.

I have found that if I get sunburned, the lesions diminish immediately, just being in the sun does not have the same impact. -Lorraine

*****

Ed's Response: Nothing surprises me anymore about what works or doesn't work for people who flake; however, your betamethazone experience did raise my eyebrows. More specifically, your bad experience with Diprolene (it burned your skin) surprised me. Diprolene is the only form of betamethazone I have used. It is rated a group 7 (strongest) corticosteroid for P treatment, so I must assume you have used other formulations of betamethazone that are not as potent. I'm sure any liquid formulation for scalp use is less potent. I read, however, that many people cannot tolerate Diprolene because of skin irritations. My derm sometimes uses it and other strong corticosteroids to "dry up" non-P lesions on patients. In his words, it's appropriate for cases where "a lesion needs to get irritated a little bit more before it will go away."

Something in what you wrote about Dovonex struck a chord and sent me clicking back to NPF for a re-read of their info on this topical vitamin D3 concoction. I stopped using it after two separate self-trials failed to impress (see link at end). You mentioned combining your Dovonex with Lubriderm (an over-the-counter lotion) and I think what I was remembering was NPF's warning not to mix Dovonex with other topical drugs, which ends up probably irrelevant. However, NPF's warning was that Dovonex' active ingredients tend to break down when compounded. Other interesting comments from NPF worth repeating:

EXCESSIVE EXPECTATIONS: Dovonex is not for everyone. Clinical trials have shown marked improvement or clearing in 60 percent of patients and modest or better improvement in 80 percent. There will be a small group of patients who will not respond to this therapy.

DOVONEX WORKS SLOWLY: If you are accustomed to the rapid response associated with super-potent steroids, don't expect the same from Dovonex. Proper use, however, may bring steady improvement of psoriasis over time.

I was probably too impatient. I endured little change through two tubes of Dovonex during my second trial (see link at end). I concluded the drug was too expensive. When the statistics are that 60% of users will experience "modest" improvement, and then you're told it will take a long time to get there, and the drug costs a lot too ... one's got to wonder, why bother?

Well, there's a good reason to bother. Dovonex is reportedly much safer to use for long periods than the super-strong corticosteroids flakers like me are hooked on. And this is not something to be taken lightly. I used Diprolene—heavily—for five years and then was diagnosed with diabetes. The PDR Family Guide to Prescription Drugs says prolonged use of Diprolene can cause Cushing's syndrome which, in turn, has been known to evolve into diabetes. Did that happen to me? Who knows? Other than grunting, none of the doctors associated with my case have commented. (One doctor, in an unusually forthcoming moment, did go so far as to say, "If you had the genetic proclivity already, it [prolonged use of Diprolene] may have had something to do with triggering it. But who's to say something else didn't trigger it, or it wasn't time for it to happen no matter what?")

You're not the first person to tell me they have had marvelous remission under the Spanish sun. But at the same time, I have also received email from Spanish flakers. Perhaps it's the change in climate—coming from somewhere else into Spain—that brings on the improvement? One correspondent found a clue in observing the insect population in Spain! (Check out: Spanish Ant Food in the Archives <wink>.)

The fact that you find getting sun burned more helpful that simply getting sun exposure is just another notation for that case we are building about trauma as a P palliative. See Reverse Koebner from the Archives and Dewke Reverse Koebner in this month's mail.

Let us know what the next millennium holds for you, Lorraine! -Ed

Ed's Dovonex Trial

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