Tar for vitiligo and lichen sclerosis. Vitiligo is a condition with a long list of treatment options, many of which aren’t all that effective. Dr. Sidbury learned of V-tar for vitiligo from Dr. Peter Lio, a pediatric dermatologist at Northwestern University, Chicago, who prescribes it frequently for stubborn areas, such as the knees and ankles. V-tar is a 30% crude coal tar product that’s water soluble. Patients apply a small amount once per week, and wash it off after 6-8 hours. V-tar is available from Dermasave Labs, a compounding pharmacy in Pleasant Valley, N.Y., he said.
For cases of lichen sclerosus where potent topical corticosteroids and topical calcineurin inhibitors are ineffective, he turns to twice-daily 6% liquor carbonis detergens in Aquaphor. It has an excellent safety profile. Irritation is rare and can be prevented using a barrier cream.
Fluconazole for erythema annulare centrifugum. Dr. Sidbury has used this on multiple occasions when standard therapy with antihistamines, topical steroids, topical calcineurin inhibitors, and/or calcipotriene didn’t work. At 3-6 mg/kg per day for 4 weeks, and a maximum daily dose of fluconazole of 200 mg, he has typically obtained a rapid reduction in itching, and skin clearance in about a week, with a sustained benefit.
This is another off-label treatment with a good safety profile, which he also frequently uses on label for neonates with candidiasis, Dr. Sidbury noted.
He reported having no financial conflicts regarding any of these therapies. SDEF and this news organization are owned by the same parent company.