Reference Guide - wsib

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Acknowledgements
The WSIB would like to acknowledge the significant contributions of the following Health
Professional Associations and workplace representatives who participated in the development of the
Program of Care for Occupational Contact Dermatitis:
• Employers’ Council of Ontario Mr. John Blogg
• Ontario Medical Association Dr. Joel DeKoven
• Ontario Pharmacists’ Association Ms. Susan Halasi
• Ontario Physiotherapy Association Ms. Annette Marcuzzi
• Ontario Podiatric Medical Association Dr. Andrew Klayman
• Registered Practical Nurses Association of Ontario Ms. Ann Marie Hann
• Ontario Professional Firefighters Association Mr. Paul Atkinson
• Ontario Psychological Association Dr. Ian Nicholson
The WSIB would also like to thank Dr. Linn Holness and her team of researchers, Dr. Joan Saary,
Dr. Roohi Qureshi, and Dr. Valerie Palda, at the Department of Occupational and Environmental
Health, St. Michael’s Hospital, University of Toronto, who completed the systematic review of
treatments for contact dermatitis that formed the foundation for this program.
Health Professional Access Line:
1-800-569-7919 or (416) 344-4526
Please call the Health Professional Access Line
if you have any questions about the Program of Care.
Hours: Monday – Friday 9:00 a.m. – 4:00 p.m.
2

Occupational Contact Dermatitis (OCD) POC Algorithm
© (WSIB) Workplace Safety and Insurance Board, 2004 Printed in Canada

Table of Contents
Program of Care Algorithm 3
Introduction 5
Occupational Contact Dermatitis Program of Care 6
Objectives 6
Screening 7
Eligibility Criteria 8
Initial Assessment 8
Treatment 9
Irritant Contact Dermatitis 10
Allergic Contact Dermatitis 12
Reassessment and Follow-up 13
Information for the Worker 13
Discharge from the Program of Care 14
Communication Requirements 14
Program of Care Requirements 14
References 17
Appendix A 18
WSIB Contact Dermatitis Formulary 18
Over the Counter Preparations 22
Over the Counter Tar Preparations 23
4

Occupational Contact Dermatitis
Program of Care Reference Guide
for Physicians
Introduction
This reference guide is intended for physicians treating patients who are being investigated for contact
dermatitis or have been diagnosed with contact dermatitis. This guide will inform you about the objectives
of the Program of Care and how to deliver this treatment program to your patients.
The Program of Care for Occupational Contact Dermatitis is an evidence-based health care delivery
plan, based on a systematic review of the scientific literature. Subsequent to implementation, periodic review
of the scientific literature will be necessary to ensure that new scientific evidence is incorporated. Clinical
and program outcome evaluations will be conducted to facilitate improvements to the Program of Care.
All of the interventions searched in the literature were determined to be “recommended” or “not
recommended” for use in the Program of Care based on the quality of available evidence of their efficacy.
The interventions reviewed are categorized as shown in Table 1:
Table 1: Key to evidence grading and strength of recommendations
Grading
A
B
C
D
E
+
Quality of Evidence
Good evidence to support the use of this intervention
Fair evidence to support the use of this intervention
Poor evidence to support the use of this intervention
Fair evidence to support rejection of this intervention
Good evidence to support rejection of this intervention
Recommended based on clinical best practice,
clinical guidelines, and/or expert committees.
Note:
Adherence to these guidelines will not ensure successful treatment in every situation. Further, these
guidelines should not be deemed inclusive of all proper methods of care or exclusive of other methods of care
reasonably directed to obtaining the same results. The ultimate judgement regarding the propriety of any specific
procedure must be made by the physician in light of all the circumstances presented by the individual patient.
The implementation of this care model is not intended to interfere with the rights and obligations of injured
workers, employers, health care professionals or the WSIB.
5

The Occupational Contact Dermatitis Program of Care
Contact dermatitis (CD) has been defined as “an inflammatory skin reaction to direct contact with noxious
agents in our environment” (Lachapelle, 1992). Substances that produce this condition after single or multiple
exposures may be either irritant (ICD) or allergic (ACD) in nature. Occupational contact dermatitis (OCD)
reflects a subcategory of both ICD and ACD in which exposure to a workplace agent causes the dermatitis.
Irritant contact dermatitis (ICD) results from contact with external agents that directly damage the epidermis, in
contrast to allergic contact dermatitis (ACD), in which the damage occurs through the host immune response as
a result of a delayed type (cell-mediated Type IV) hypersensitivity reaction. The most common clinical
expression of this induced inflammation is dermatitis, often called eczema.
Objectives
The objectives of the Program of Care are to:
• enable early identification and appropriate diagnosis of workers with occupational contact
dermatitis
• provide best possible evidence-based quality care to workers with OCD
• facilitate safe, timely and sustainable return to suitable work
• prevent re-exposure to irritating and/or sensitizing agents
• reduce recurrence of symptoms
• help the worker return to the best possible level of overall function and quality of life.
The Program of Care is also intended to improve clinical and return-to-work outcomes through education
of the worker on symptom management, the correct use of medications, and ways to avoid re-exposure in the
workplace, in the home, and at leisure.
6

Screening
The purpose of the screening and initial assessment, completed at the worker’s first contact with the
physician, is to determine the appropriateness of the worker for the Program of Care, to determine
whether any specialist referrals are required, and to begin treatment.
The diagnosis of contact dermatitis should be suspected in workers in high-risk occupations and/or industry
sectors with known workplace agents (e.g. agriculture, health care, manufacturing). Physicians should determine
whether there is a suspected workplace agent (allergen or irritant) that can be identified. Screening should
include determination of the following:
A. Did the skin condition start after the worker started the job?*
OR
Did the skin condition become worse after the worker started the job?*
AND
B. Are symptoms better on weekends or holidays off work?
*NOTE: “started the job” includes changing job duties or locations within the same workplace.
Those patients who answer “yes” to BOTH A and B should be enrolled in the Program of Care.
Referral to a specialist with experience diagnosing and treating occupational contact dermatitis should be
considered when any of the following are suspected:
• all cases of possible ACD
• ICD with allergic features
• chronic ICD
• complicated OCD (e.g., not improving, deteriorating, confounded by another skin disease
such as psoriasis).
Following referral, the specialist will:
• confirm a relationship between contact dermatitis and workplace exposure
• conduct diagnostic tests (e.g. industrial patch testing) to identify a specific allergen.
NOTE: Only a small number of physicians in Ontario are able to conduct patch testing for industrial allergens. Please
call the WSIB Health Professional Access Line to obtain a list of locations where this specialized
testing is performed.
7

Eligibility Criteria
Inclusion Criteria
The Program of Care is appropriate for workers in Ontario:
• with a positive screen for occupational contact dermatitis (either irritant or allergic), and/or a current
diagnosis of occupational contact dermatitis by a dermatologist, occupational medicine physician or
other specialist with experience diagnosing occupational contact dermatitis (uncomplicated ICD may
also be diagnosed by a family physician)
AND
• presenting with a new onset skin disease which is workplace-induced.
Workers may be enrolled in the Program of Care if they are still working (regular or modified duties)
or off work.
Workers who do not meet these criteria should be treated outside the Program of Care.
Exclusion Criteria
The Program of Care is not designed for ill workers with:
• chemical burns
• urticaria
Workers with either of these conditions should be treated outside the Program of Care.
Initial Assessment
In order to make the Program of Care initial assessment visit feasible for primary care physicians, the
clinical experience of committee members was used to select the following essential elements for the initial
assessment of the worker from the much longer list contained in the American Academy of Dermatology
Guidelines (www.aad.org). Physicians may include other assessment components as they consider appropriate.
1. History may include the following:
General medical status
Onset of Dermatitis
(1) Location
(2) Symptoms
(3) Description
Progression
(1) Relation between exposure and time interval of dermatitis
(2) Relation between workplace exposure and development of symptoms
Remissions
(1) Response to treatment and rapidity of recurrence after discontinuing medication (if applicable)
Occupational history
(1) Nature of work
(2) How long in current job/job duties
(3) Changes in workplace procedures, chemical exposure, or environment exposure
(4) Protective measures
8

Medical history
(1) History of contact dermatitis: nature, severity, and causative agent(s) if known
(2) Previous treatment including medications
(a) At onset
(b) Self-treatment/over-the-counter treatments, complimentary therapies, herbal medicine
(c) By other physicians
(3) History of atopy – allergies, hayfever, asthma, atopic eczema
2. Physical examination may include the following:
Location – specify site(s)
Involved versus uninvolved skin
(a) Demarcation: Sharp or unclear
(b) Other
Lesion type & characteristics
(a) Acute
(b) Chronic
The detailed findings from the examination and assessment of the worker are recorded on the Program
of Care Screening and Initial Assessment Report. A Program of Care Screening and Initial Assessment
Report should be completed and submitted to the WSIB within 24-48 hours of the initial assessment visit.
Treatment
The activities in the Program of Care are depicted in the algorithm (p. 3). Management will differ
depending on whether the worker has ACD or ICD, and whether the dermatitis is acute, chronic or
complicated.
Although the initial presentation may appear as an uncomplicated case of ICD, complications may
develop at any time during treatment. If complications develop, workers should be referred immediately to
a specialist for appropriate management. It should also be noted that workers with acute ICD will need to
be seen at more frequent intervals (i.e. every 2-4 weeks post-enrolment) until the acute features of the
dermatitis resolve.
Flares may occur at any time during treatment. The treating physician should see patients who
experience flares in their condition as soon as possible, within no more than 2 weeks.
The following is a description of the interventions in the Contact Dermatitis Program of Care.
Interventions for irritant and allergic contact dermatitis are described separately. Within each category,
both treatment interventions and interventions to prevent exacerbation and/or recurrence of symptoms
are described.
The treating physician determines selection of specific interventions.
9

Irritant Contact Dermatitis (ICD)
Treatment
A
Hi-lipid content moisturizers had good evidence of their efficacy in the treatment of ICD. Studies
demonstrated the effect of hi-lipid content moisturizers in accelerating barrier regeneration (Held et al.
2001). Based on the evidence, the moisturizer chosen should have:
- high lipid content
- either physiological lipids (e.g. fatty acids, cholesterol) or non-physiological lipids (e.g. petrolatum)
although the latter were ranked highest in the ability to promote recovery of irritated skin
- few ingredients.
A list of hi-lipid content moisturizers is provided in Appendix A (page 22).
+
Moderate to high-potency topical corticosteroids
Moderate to ultra-high potency topical corticosteroids are widely used in the treatment of ICD, however
there was a lack of scientific evidence of their efficacy. Their use is recommended based on the clinical
opinion of the consensus table members. A list of topical corticosteroids, which are on the WSIB Drug
Formulary for Dermatitis, appears in order of potency in Appendix A (pages 18-21).
The desire to reduce the risks of side effects by using less potent preparations must be balanced with the
desire to gain control of a flare quickly with more potent preparations.
Prevention
A
&
B
A
B
Recommended Interventions:
The following interventions had good or fair evidence of their efficacy in the prevention of symptoms of
ICD:
Hi-lipid content moisturizers
Two good quality studies (Held & Agner, 2001; Loden, 1997) and 4 fair quality studies
(Schiemann-Willers et al, 2002; Ramsing & Agner, 1997; Held et al, 1999 and Zhai et al, 2002) found
that moisturizers with a high lipid content were effective in preventing ICD. Better protection was afforded
by fats with higher linoleic acid content (see Appendix A, page 22).
Barrier creams containing dimethicone
One good quality study (Zhai et al, 2000) found barrier creams containing the active ingredient
dimethicone to be effective in preventing experimentally-induced ICD, and superior to vehicle
treated or untreated control.
Cotton liners under occlusive gloves
One fair quality study (Ramsing & Agner, 1996) found that use of a cotton liner under occlusive
gloves led to better results than the glove alone.
10

Education
B
+
An evidence-based skin care program is recommended both based on the systematic review
(2 fair quality cohort studies; Held et al. 2002; Held et al. 2001), and the clinical experience of
committee members. The educational intervention in the Held (2002) study was delivered in
2 sessions, 14 days apart, and was reinforced 6 weeks later. The components of the education
intervention included the following:
I. Basics of Contact Dermatitis
- anatomy and physiology of normal and diseased skin
- description of contact dermatitis and its symptoms
- acute and chronic contact dermatitis
- irritant and allergic contact dermatitis
II. Practical Instructions on Skin Care
- hand washing
- moisturizers
- protective gloves
- cotton gloves
- avoiding irritants/sensitizers in the workplace, at home, and at leisure
- booklet summarizing practical measures
III. Monitoring Daily Behaviour
- card to record behaviours and symptoms
- symptom monitoring
Interventions not recommended for ICD:
+
There was good evidence of the efficacy of barrier creams containing perfluoropolyethers
(compounded extemporaneously); however they are not recommended in the Program of Care
since they are not commercially available in Canada.
E
The use of aluminum chlorohydrate in the prevention of ICD is not recommended due
to good evidence of its lack of efficacy.
11

Allergic Contact Dermatitis (ACD)
Treatment
Recommended Interventions:
The following interventions are recommended in the Program of Care because of good evidence of their
efficacy in the treatment of allergic contact dermatitis.
A
Moderate to high-potency topical steroids
There was good evidence of the efficacy of moderate to high potency topical steroids in the
treatment of ACD, based on the results of two RCTs (Hachem et al, 2002; Queille-Roussel et al, 1990)
and two cohort studies (Hachem et al, 2001; Parneix-Spake et al, 2001). Specific topical steroids in these
studies included: Fluticasone propionate .05%, Clobetasone butyrate .05% and Clobetasol propionate
.05%. Appendix A contains a list of topical corticosteroids listed in the WSIB Drug Formulary for
Dermatitis in order of potency (see pages 18-21).
+
Topical macrolide immunomodulators
NOTE: Topical macrolide immunomodulators are not listed in the WSIB Drug Formulary for
Dermatitis – approval for their use should be obtained from the WSIB for each individual case.
Topical macrolide immunomodulators are a new class of drugs that are being used increasingly for the
treatment of a variety of skin disorders, including contact dermatitis. Currently, there is insufficient evidence
to recommend their use in the Program of Care; it is possible that such evidence could be available in the
next 12-24 months. An update of the scientific review in 12-24 months is indicated to ensure that these
treatments are properly evaluated, and, if necessary, incorporated into the Program of Care. In the interim,
their use should be considered only in exceptional cases in which the patient has failed to respond to topical
corticosteroids.
Prevention
B
There were no good quality studies demonstrating the efficacy of general prevention interventions for ACD.
However, there is fair quality evidence for the prevention of exposure to specific allergens: fair evidence exists
that TSP (Vidmar & Iwane, 1999) and organoclay (Marks et al, 1995) can prevent Rhus dermatitis, and
that DPTA can prevent reactions to nickel, cobalt, and copper (Worl et al, 2001).
+
Education
There was no evidence of the efficacy of an educational program for ACD. The educational program
supported by the evidence for ICD can be used for ACD, but should be augmented to include how to
recognize and avoid causal allergens and cross reactants at work, home, and leisure.
12

Reassessment and Follow-up
The Program of Care begins at the initial assessment visit and continues for a maximum of 6 months.
The duration of the program, frequency, and timing of follow-up visits are detailed on the Algorithm (see
page 3). Workers with acute contact dermatitis will need to be followed more closely. In acute cases, followup
should occur 2-4 weeks following the initial assessment. All workers in the Program of Care will be
reassessed at 6 to 8 weeks, 3 months and 6 months. The maximum length of the program is 6 months.
Follow-up and reassessment will determine if the worker is progressing and if the goals of treatment
are being achieved. This includes symptom monitoring, physical examination, adjustments to medications
as necessary (e.g., tapering down dosage), and health-related quality of life. Referral to a specialist in
occupational contact dermatitis should be considered when the worker is not progressing as expected
or his or her condition is deteriorating.
An additional component of the reassessment should include a review of potential barriers to program
compliance. Factors affecting patient compliance have been broadly categorized as social issues, emotional
issues, educational issues, medication dosing schedules, and medication side effects. Emotional issues may
include self-denial or mood disorders. Social anxiety has been documented in the scientific literature among
individuals with contact dermatitis, particularly when dermatitis is on the face. This may also occur, to a
lesser degree, when the dermatitis is on the hands. Results of the follow-up reassessment may indicate that
referral outside the Program of Care to an appropriate allied health professional is required to address key
issues and barriers to program compliance. Such referrals should be considered on a case-by-case basis.
A Program of Care Reassessment Report should be completed and submitted to the WSIB following
the 6-8 week follow-up, and 3-month follow-up. A Care & Outcomes Summary Report should be submitted
following the 6-month follow-up visit.
Information for the Worker
Occupational Disease Fact Sheet
"Workplace Contact Dermatitis: Facts for Workers in Ontario" is a fact sheet that provides educational
information including: a description of contact dermatitis and its symptoms, how irritant and allergic
contact dermatitis are caused, and how possible cases of occupational contact dermatitis are handled by
physicians. The fact sheet also provides a list of irritants and allergens associated with various jobs.
Additional copies can be downloaded from the WSIB website at www.wsib.on.ca
13

Discharge from the Program of Care
Workers should be discharged from the Program of Care when their symptoms have stabilized and no
further clinical intervention is required following the 6-8 week, 3-month, or 6-month follow-up. The
maximum length of the Program of Care is 6 months from the date of enrolment in the program. Workers
should also be discharged from the Program of Care if they develop other serious medical conditions that
affect their ability to attend follow-up visits or to complete the treatment program.
A Care & Outcomes Summary Report should be completed and submitted to the WSIB whenever the
worker leaves the Program of Care for any reason.
Transition to Work
Workers should be moved towards a safe transition to work as early as possible. Measures should be
taken to prevent re-exposure to the workplace agent causing the dermatitis, either by removing the agent
from the workplace, or the use of personal protective equipment, or the removal of the worker from
exposure to the causative agent.
Communication Requirements
Standard WSIB Reporting Requirements
Following the new onset of symptoms suggestive of contact dermatitis, the worker, employer, and first
physician will complete the appropriate documentation to initiate the WSIB adjudication process. These
forms include:
• Form 6 (Worker’s Report of Injury/Disease) to be completed by the worker
• Form 7 (Employer’s Report of Injury/Disease) to be completed by the employer
• Program of Care Screening & Initial Assessment Report OR Health Professional’s Report
(Form 8/8D).
Program of Care Requirements
Reporting of Health Status and Recovery
Requirements for reporting the worker’s health status, progress, and outcomes include:
Physician-completed assessments and report forms
• Screening & Initial Assessment Report: baseline data collected to enable treatment planning
• Reassessment Report: completed when the worker's needs dictate that he/she moves to another
phase of care
• Care & Outcomes Summary Report: a summary of the worker's achieved recovery, and when
necessary, recommendations.
The duration of the initial assessment and reassessment visits may vary and will be determined
by the treating physician.
14

Communication among workplace parties
Communication is an important element in the success of the Program of Care and the health of
the worker, and may include telephone conversations, written reports and one-on-one discussion with
the ill worker.
The frequency of communication will vary from case to case depending on the circumstances of the
worker and the progress involved. Communication during the recovery and return to work process may
include the following parties:
• the ill worker
• the treating physician and/or specialist
• the employer
• the WSIB service delivery team: adjudicator, nurse case manager, and medical consultant
• other concurrent or future treatment providers.
In order to facilitate return to work planning, it is extremely important that the physician contact the
employer regarding the workers ability to return to work. Communication with the employer should occur
when the screening and initial assessment is completed, when the worker is fit for work with modifications
or limitations, or when the worker may return to regular work with no restrictions.
If the worker is referred to a specialist (e.g. for ACD), it may not be possible to determine the
workplace modifications or limitations upon completion of the screening and initial assessment.
This information will be available following the specialist’s assessment.
NOTE: Communication between the physician and the employer is restricted to discussion of the worker’s functional
abilities unless the worker’s informed consent is obtained.
15

Once a claim for benefits has been made, the Workplace Safety and Insurance Act gives the WSIB the
authority to review any relevant report from a physician, hospital or health facility, or request a verbal report
from such a person or facility without first obtaining the worker’s informed consent.
Key communications and reporting should occur at certain times during the Program of Care:
Timeframe
Key Communications
After first visit
At 2-4 weeks and 2-week
intervals until resolved
At 6-8 week follow-up
reassessment, at 3 and 6
months, when necessary,
and at discharge
n complete and submit (within 24 to 48 hours) Screening & Initial
Assessment Report to WSIB
n ongoing discussion with worker throughout the Program of Care
n contact employer
n follow-up for workers with acute contact dermatitis
n complete and submit Reassessment Report or Care & Outcomes
Summary Report to WSIB
n ongoing discussion with worker throughout the Program of Care
n contact employer
At any time before
making referrals to allied
health professionals
n contact the WSIB to ensure that the claim is approved
NOTE: This does not apply to referral of patients to specialists for diagnosis.
Timely submission of the Screening & Initial Assessment Report, the Reassessment Report, and the
Care & Outcomes Summary Report is essential. In addition, the WSIB should be contacted when:
• the worker is not progressing as expected
• the worker is referred to another health professional
• medical or other complications arise that warrant further evaluation outside the Program of Care
• any other issue arises.
16

References
Hachen JP, De Paepe K, Vanpee E et al. Efficacy of
topical corticosteroids in nickel-induced contact allergy.
Clinical and Experimental model using a contact
allergy patch test combined with TEWL
measurements. Dermatology 2001; 202:314-319.
Held E, Agner T. Effect of Moisturizers on Skin
Susceptibility to Irritants. Acta Derm Venerol
2001; 81: 104-107.
Held E, et al. Prevention of work-related skin problems
in student auxiliary nurses. An intervention study.
Contact Dermatitis 2001; 44: 297-303.
Held E, Lund H, Agner T. Effect of different moisturizers
on SLS-irritated human skin. Contact Dermatitis
2001; 44:229-234.
Held E, Mygind K, Wolff C et al. Prevention of work
related skin problems: an intervention study in wet work
employees. Occup Environ Med 2002; 59: 556-561.
Held E, Sveinsdottir S, Agner T. Effect of long-term use
of moisturizer of skin hydration, barrier function and
susceptibility to irritants. Acta Derm Venerol ( Stockh)
1999; 79: 49-51.
Lachapelle JM. Historical Aspects. In: Rycroft RJG,
Menne T, Frosch PJ, Benezra C. Textbook of Contact
Dermatitis. Springer-Verlag Berlin1992.
Loden M. Barrier recovery and influence of irritant
stimuli in skin treated with a moisturizing cream.
Contact Dermatitis 1997; 36: 256-260.
Marks JG, Belsito DV, Deleo V, et al. North American
Contact Dermatitis group test results 1996-1998. Arcg
Dermatol 2000; 136: 272.
Quielle-Roussel C, Duteil L, Padilla JM et al. Objective
assessment of topical anti-inflammatory drug activity on
experimentally induced nickel contact dermatitis:
comparison between visual scoring, colorimetry, laser
Doppler velocimetry and transepidermal water loss.
Skin Pharmacol 1990; 3: 248-255.
Ramsing D and Agner T. Effect of glove occlusion on
human skin (II). Contact Dermatitis 1996; 34: 258-262.
Ramsing D and Agner T. Preventive and therapeutic
affects of moisturizer. Acta Derm Venerol (Stockh)
1997; 77: 335-337.
Schleimann-Willers S et al. Natural vegetable fats in the
prevention of irritant contact dermatitis. Contact
Dermatitis 2002; 46: 6-12.
Vidmar DA and Iwane MK. Assessment of the ability of
the topical skin protectant (TSP) to protect against
contact dermatitis to urushiol (Rhus) antigen. Am J
Contact Dermatitis 1999; 10(4): 190-197.
Wohrl S et al. A cream containing the chelator DTPA
(diethylenetriaminepenta-acetic acid) can prevent
contact allergic reactions to metals. Contact Dermatitis
2001; 44: 334-228.
Zhai H, Brachman F, Pelosi A et al. A bioengineering
study on the efficacy of a skin protectant lotion in
prevention SLS-induced dermatitis. Skin Research and
Technology 2000; 6: 77-80.
Zhai H, Schmid R, Levin C et al. Prevention and
therapeutic effects of a model emulsion on gloveinduced
irritation and dry skin in man. Occup Environ
Med 2002; 50: 134-138.
17
Parmeix-Spake A, Goustas P, Green R. Eumovate
(clobetasone butyrate) 0.05% cream with its
moisturizing emollient base has better healing properties
than hydrocortisone 1% cream: a study in nickel-induced
contact dermatitis. J Dermatol Treat 2001; 12: 191-197.

APPENDIX A: WSIB Dermatitis Formulary
Topical Corticosteroids in order of potency
NOTE: The products listed were covered under the WSIB Drug Benefit Program at the time of publication.
Products may be added or removed at any time.
POTENCY GENERIC NAME TRADE NAME DIN
Ultra High Beclomethasone Dipropionate 0.5% Diprolene cream 00688622
(in propylene glycol base) Diprolene ointment 00629367
Clobetasol Propionate 0.5% Clobetasol cream (Prempharm) 02230071
Clobetasol ointment (Prempharm) 02230072
Clobetasol scalp lotion (Prempharm) 02230073
Clobetasol cream (Taro) 02245523
Clobetasol ointment (Taro) 02245524
Clobetasol solution (Taro) 02245522
Dermovate cream 02213265
Dermovate ointment 02213273
Dermovate scalp lotion 02213281
Gen-Clobetasol cream 02024187
Gen-Clobetasol ointment 02026767
Gen-Clobetasol scalp lotion 02216213
Novo-Clobetasol cream 02093162
Novo-Clobetasol ointment 02126192
PMS-Clobetasol cream 02232191
PMS-Clobetasol ointment 02232193
PMS-Clobetasol solution 02232195
Ratio-Clobetasol cream 01910272
Ratio-Clobetasol ointment 01910280
Ratio-Clobetasol lotion 01910299
18

POTENCY GENERIC NAME TRADE NAME DIN
High Amcinonide 0.l% Amcinonide cream 02247098
Amcort cream 02246714
Cyclocort cream 02192284
Cyclocort ointment 02192268
Cyclocort lotion 02192276
Betamethasone Dipropionate 0.05% Diprosone cream 00323071
Diprosone ointment 00344923
Diprosone lotion 00417246
Ratio-Topilene lotion 01927914
Ratio-Topilene cream 00849650
Ratio-Topilene ointment 00849669
Ratio-Topisone ointment 00805009
Ratio-Topisone lotion 00809187
Rolene cream 02122073
Rolene pommade 02122081
Rolene lotion 02122065
Rosone cream 02122049
Rosone pommade 02122057
Taro-sone cream 01925350
Flucinonide 0.05% Lidemol cream 02163152
Lidex cream 02161923
Lidex ointment 02161966
Lyderm cream 00716863
Lyderm gel 02236997
Lydonide cream 02187655
Lydonide ointment 02187663
Lydonide emollient cream 02187671
Tiamol cream 00598933
Topactin cream 00816132
Topactin emollient cream 02240269
Topsyn gel 02161974
Halocinonide 0.l% Halog cream 02011921
Halog ointment 02010283
Halog solution 02010291
19

POTENCY GENERIC NAME TRADE NAME DIN
Medium Beclomethasone Dipropionate 0.025% Propaderm ointment 02089599
Betamethasone Valerate 0.05%, 0.1% Betaderm 0.1% cream 00716626
Betaderm 0.05% cream 00716618
Betaderm 0.l% scalp lotion 00716634
Betaderm 0.1% ointment 00716650
Betaderm 0.05% ointment 00716642
Betamethasone val 0.l% lotion 00726486
Betnovate 0.1% lotion 02100193
Celestoderm -V 0.l% cream 00027901
Celestoderm-V/2 0.05% cream 00027898
Celestoderm-V 0.l% ointment 00028363
Celestoderm-V/2 0.05% ointment 00028355
Ratio-Ectosone 0.1% cream 00535435
Ratio-Ectosone 0.05% mild cream 00535427
Ratio-Ectosone 0.05% mild lotion 00653209
Ratio-Ectosone 0.1% scalp lotion 00653217
Ratio-Ectosone 0.l% lotion 00750050
Valisone scalp 0.l% lotion 00027944
Clobetasone Butyrate 0.05% Eumovate cream 02214415
Eumovate ointment 02214423
Diflucortolone Valerate 0.l% Nerisone oily cream 00587818
Nerisone cream 00587826
Nerisone ointment 00587834
Flumethasone Pivalate 0.03% Fluoderm 0.025% cream 00716790
Fluoderm 0.01% cream 00716782
Fluoderm 0.025% ointment 00716812
Fluocinolone Acetonide 0.01%, 0.025% Synalar 0.025% cream 02162539
Synalar 0.01% lotion 02162504
Synamol 0.01% cream 02163489
Mometasone Furoate 0.1% Elocom cream 00851744
Elocom ointment 00851736
Elocom lotion 00871095
PMS-mometasone cream 02244767
PMS-mometasone ointment 02244769
PMS-mometasone lotion 02244768
Triamcinolone Acetonide 0.01%, 025% Aristocort R cream 02194058
Aristocort R ointment 02194031
Kenalog 0.1% ointment 01999761
Triaderm 0.025% cream 00716952
Triaderm 0.01% cream 00716960
Triaderm 0.01% ointment 00716987
20

POTENCY GENERIC NAME TRADE NAME DIN
Low Desonide Desocort 0.05% cream 02048639
Desocort 0.05% ointment 02115522
Desocort 0.05% lotion 02115514
PMS-desonide 0.05% cream 02229315
PMS-desonide 0.05% ointment 02229323
Hydrocortisone Tridesilon 0.05% cream 02154862
Tridesilon 0.05% ointment 02154870
Cortate 0.5% cream 00513288
Cortate 0.5% ointment 00513261
Cortate l% cream 00502200
Cortate l% ointment 00502197
Cortoderm 0.5% ointment 00716685
Cortoderm 1% ointment 00716693
Emocort l% cream 00192597
Emocort l% lotion 00192600
Hydrocortisone 0.5% cream 00551953
Hydrocortisone 1% cream 00551945
Novo-hydrocort 0.5% cream 00461911
Novo-hydrocort 1% cream 00461903
Methylprednisolone Medrol Veriderm 0.25% cream 00031062
21

Over The Counter Preparations
NOTE: Over the counter products are not covered under the WSIB Drug Benefit Program at this time.
CLASS GENERIC NAME TRADE NAME DIN
Barrier Product Dimethicone Marathon Protective Barrier 02238789
Cream 20%
Baza Cleanse and Protect Lotion 2% 02243966
Clean N Moist Spray 1.5% 02144638
Barrier Crème 1.5% 02144522
Therapeutic Lotion (unscented) 3% 02240213
Dimethicone (in lipid base) Moisturel Lotion 3% 01909169
Moisturel Cream l% 01909142
Dimethicone (menthol) Gold Bond Extra Strength 02237563
Lotion 5%
Gold Bond Regular Strength 02237526
Lotion 5%
High Lipid Silicone Barriere Cream 20% 02060841
Content
Moisturizers Petrolatum Prevex Cream 67 (67%) 00635189
Vaseline Petroleum Jelly (100%) 00365351
White Petroleum Jelly USP (100%) 00741515
White Petroleum Jelly BP (100%) 00600679
22

Over the Counter Tar Preparations (containing at least 1% coal tar)
NOTE: The use of these products may be appropriate for patients with atopic dermatitis and OCD.
Over the counter tar preparations are not covered under the WSIB Drug Benefit Program at this time.
COAL TAR ADDITIONAL
STRENGTH INGREDIENTS TRADE NAME DIN
Coal tar 1% Exorex gel 1-Eml –1 (gel emulsion) 02184672
Exorex Formula 1% 00632295
Neutrogena T/gel Extra 02238642
Tersa Tar Mild shampoo 00632295
Zetar Shampoo 02220393
Coal tar 1.25% Psoriasin gel 02240152
Coal tar 1.4% Tegrin Medicated Shampoo 01918990
Coal tar 2% Doak Oil 2 00579955
Exorex gel 2-EML-2 (gel emulsion) 02184680
Salicylic acid 2%, Sulphur 2% Sterex Shampoo 00444448
Coal tar 2.5% Balnetar Liquid 01908855
Coal tar 3% Tersatar Shampoo 3% 00632309
Coal tar 4% Salicylic acid 2% Medi-Dan Shampoo 00888591
Pentrax Gold Shampoo 4 00864706
Coal tar 5% Estar gel-5 01909185
Salicylic acid 2% Tardan Shampoo 00266493
Coal tar 7.5% Menthol 1.5% Denorex Medicated Shampoo-Regular 01942379
Coal tar 8% Salicylic acid 2% P & S Plus Gel 00560448
Salicylic acid 2%, Menthol 1% X-Tar Shampoo 00800694
Coal tar 10% Doak oil Forte 00579971
Targel 10% 00344508
Salicylic acid 3% Targel SA 00510335
Salicylic acid 4% Sebcur-T 00666114
Salicylic acid 3%, Menthol 1% X-Seb T Plus Shampoo 00866601
Salicylic acid 4% X-Seb T Extra Strength Shampoo 00509906
Menthol 1.5% Denorex Medicated Shampoo 02106299
Coal tar 20% Odans LCD 00358495
Coal tar 40.8% Salicylic acid 1% Oxipor Lotion 02230134
Coal tar 100% Tar distillate 100 00579963
Tar Soaps Mazon Medicated Soap 0.5% 01981293
Polytar Soap 00251372
23

Notes
24

© (WSIB) Workplace Safety and Insurance Board, 2003 Printed in Canada
2855A 05/04