Nov-Dec '08 | briefing | mail | interviews | articlespsorchat |  don't say this | flaker creativity | flakers' jargon | spouses corner | other places | archives | send mail | ed dewkesearch | acknowledgments | legal stuff | Flake: Confessions of a Psoriatic  | 2008 Ed Dewke

Guttate P and Dovobet
from Fiona D.

Hello. Not sure if you can help but doctors here have not helped much!  I have plaque psoriasis, but after a strep throat infection I developed guttate psoriasis as well. I went to an NHS (National Health Service, UK) walk in clinic for some penicillin for the strep (takes a while to get a doctor’s appointment in the UK) but they could not advise on the guttate.

I have been using Dovobet on the plaque psoriasis so when I got the guttate, I also applied it to this. After a web search, I have just found out it is not supposed to be used for guttate! I have only been using it for a week and have had no ill effects; mind you it hasn’t really helped the guttate either.

What I am confused about is whether I can still use Dovobet on the plaque psoriasis while having the guttate and what on earth I should put on the guttate.

The use of Dovobet is very confusing for me. I read that it should only be used short-term, but doctors say that there is no problem in using it long-term. I have been using this for over 2 years now and it was doing quite well in keeping it in check until I got Strep. How long do most people use Dovobet?

I hope you can help. Am feeling like it’s all out of my control and getting to see a dermatologist here can mean a 6 month + wait.

Best wishes, -Fiona D.

*****

Ed’s Response: Sorry to hear about your difficulties across the pond. Over here, guttate treatment is determined based, at least partially, on the extent of coverage. One of the reasons derms will frown on using a corticosteroid (Dovobet is 50%~ betamethasone, itself a potent corticosteroid) is because guttate tends to involve large areas of skin with relatively small (teardrop) lesions and most people won't just apply the med to each little lesion; they'll spread it on like a lotion, instead.  Probably the most common treatment used for guttate over here is light therapy, which requires regular visits to a clinic and might be inconvenient, difficult, or both for you.

On the other hand, Dovobet was INVENTED so topical corticosteroids could become part of a topical treatment withOUT becoming ALL OF IT.  Dovobet is calcipotriene (a synthetic vitaminD3) combined with betamethasone. It is supposed to allow prolonged use with less danger of skin thinning or other steroid-induced side effects. Perhaps your doc thinks your guttate is too widespread for safe use of Dovobet. Calcipotriene in Dovobet is, by itself, sold as Dovonex in the U.S.. You might ask your doc if this “half” of Dovobet is available in the UK by itself, and if you might try this on your guttate P.  Hopefully, that inquiry wouldn't take 6 months!

Best of luck to you, Fiona.  -Ed

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