DOSAGE AND ADMINISTRATION
Topical corticosteroids are generally applied to the affected area as a thin film from 1 to 4 times daily, depending on the severity of the condition.
A small quantity of Cordran Lotion should be rubbed gently into the affected area 2 or 3 times daily.
Occlusive dressings may be used for the management of psoriasis or recalcitrant conditions.
If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted.
Use With Occlusive Dressings
The technique of occlusive dressings (for management of psoriasis and other persistent dermatoses) is as follows:
Remove as much as possible of the superficial scaling before applying Cordran Lotion. Soaking in a bath will help soften the scales and permit easier removal by brushing, picking, or rubbing.
Rub the lotion thoroughly into the affected areas.
Cover with an occlusive plastic film, such as polyethylene, Saran Wrap™, or Handi-Wrap®. (Added moisture may be provided by placing a slightly dampened cloth or gauze over the lesion before the plastic film is applied.)
Seal the edges to adjacent normal skin with tape or hold in place by a gauze wrapping.
For convenience, the patient may remove the dressing during the day. The dressing should then be reapplied each night.
For daytime therapy, the condition may be treated by rubbing Cordran Lotion sparingly into the affected areas.
In more resistant cases, leaving the dressing in place for 3 to 4 days at a time may result in a better response.
Thin polyethylene gloves are suitable for treatment of the hands and fingers; plastic garment bags may be utilized for treating lesions on the trunk or buttocks. A tight shower cap is useful in treating lesions on the scalp.
Occlusive Dressings Have the Following Advantages—
Percutaneous penetration of the corticosteroid is enhanced.
Medication is concentrated on the areas of skin where it is most needed.
This method of administration frequently is more effective in very resistant dermatoses than is the conventional application of Cordran.
Precautions to Be Observed in Therapy With Occlusive Dressings— Treatment should be continued for at least a few days after clearing of the lesions. If it is stopped too soon, a relapse may occur. Reinstitution of treatment frequently will cause remission.
Because of the increased hazard of secondary infection from resistant strains of staphylococci among hospitalized patients, it is suggested that the use of occlusive plastic films for corticosteroid therapy in such cases be restricted.
Generally, occlusive dressings should not be used on weeping, or exudative, lesions.
When large areas of the body are covered, thermal homeostasis may be impaired. If elevation of body temperature occurs, use of the occlusive dressing should be discontinued.
Rarely, a patient may develop miliaria, folliculitis, or a sensitivity to either the particular dressing material or a combination of Cordran and the occlusive dressing. If miliaria or folliculitis occurs, use of the occlusive dressing should be discontinued. Treatment by inunction with Cordran Lotion may be continued. If the sensitivity is caused by the particular material of the dressing, substitution of a different material may be tried.
Warnings— Some plastic films are readily flammable. Patients should be cautioned against the use of any such material.
When plastic films are used on pediatric patients, the persons caring for the patients must be reminded of the danger of suffocation if the plastic material accidentally covers the face.