BNF for Children 2011-2012

570 13.5.2 Preparations for psoriasis BNFC 2011–201213 SkinBath preparationsCoal Tar Solution, BPSolution, coal tar 20%, polysorbate ‘80’ 5%, in alcohol(96%), net price 500 mL = £8.16. Label: 15Excipients include polysorbatesDoseUse 100 mL in an adult-size bath, and proportionally lessfor a child’s bathNote Strong Coal Tar Solution BP contains coal tar 40%Pinetarsol c (Crawford)Bath oil, tar 2.3% in a light liquid paraffin basis, netprice 200 mL = £4.75, 500 mL = £7.95Excipients include fragranceDoseEczema and psoriasisUse 15–30 mL in adult-size bath or apply directly to wetskin and rinse after a few minutes; can be used as a soapsubstituteGel, tar 1.6%, net price 100 g = £4.95DoseEczema and psoriasisApply directly to wet skin and rinse after a few minutes;can be used as a soap substituteSolution, tar 2.3%, net price 200 mL = £4.45, 500 mL= £7.45DoseEczema and psoriasisUse 15–30 mL in adult-size bath or dilute 15 mL with 3litres of water and apply to affected areas or applysolution directly to wet skin and rinse after a few minutes;can be used as a soap substitutePolytar Emollient c (Stiefel)Bath additive, coal tar solution 2.5%, arachis (peanut)oil extract of coal tar 7.5%, tar 7.5%, cade oil 7.5%,liquid paraffin 35%, net price 500 mL = £5.78Excipients include isopropyl palmitateDosePsoriasis, eczema, atopic and pruritic dermatosesUse 2–4 capfuls (15–30 mL) in adult-size bath and proportionallyless for a child’s bath; soak for 20 minutesPsoriderm c (Dermal)Bath emulsion, coal tar 40%, net price 200 mL =£2.74Excipients include polysorbate 20DosePsoriasisUse 30 mL in adult-size bath, and proportionally less for achild’s bath; soak for 5 minutesWith corticosteroidsAlphosyl HC c (GSK Consumer Healthcare) ACream, coal tar extract 5%, hydrocortisone 0.5%,allantoin 2%, net price 100 g = £3.10. Label: 28.Potency: mildExcipients include beeswax, cetyl alcohol, hydroxybenzoates (parabens),isopropyl palmitateDosePsoriasisChild 5–18 years apply thinly twice dailyDithranolDITHRANOL(Anthralin)Cautions avoid use near eyes and sensitive areas ofskin; see also notes aboveContra-indications hypersensitivity; acute and pustularpsoriasisPregnancy no adverse effects reportedBreast-feeding no adverse effects reportedSide-effects local burning sensation and irritation;stains skin, hair, and fabricsLicensed use Dithrocream c and Psorin c licensedfor use in children (age range not specified bymanufacturer); Micanol c licensed for use inchildren, but not recommended for infants or youngchildren (age range not specified by manufacturer)Indication and doseSubacute and chronic psoriasisSee notes above and under preparationsNote Some of these dithranol preparations also containcoal tar or salicylic acid—for prescribing information seeunder Tars or under Salicylic AcidNon-proprietary preparations1Dithranol Ointment, BP AOintment, dithranol, in yellow soft paraffin; usualstrengths 0.1–2%. Part of basis may be replaced byhard paraffin if a stiffer preparation is required.Label: 281. A if dithranol content more than 1%, otherwise may besold to the publicDithranol Paste, BPPaste, dithranol in zinc and salicylic acid (Lassar’s)paste. Usual strengths 0.1–1% of dithranol. Label: 28Proprietary preparationsDithrocream c (Dermal)Cream, dithranol 0.1%, net price 50 g = £3.77; 0.25%,50 g = £4.04; 0.5%, 50 g = £4.66; 1%, 50 g = £5.42; A2%, 50 g = £6.79. Label: 28Excipients include cetostearyl alcohol, chlorocresolDoseFor application to skin or scalp; 0.1–0.5% cream suitablefor overnight treatment, 1–2% cream for max. 1 hourMicanol c (GP Pharma)Cream, dithranol 1% in a lipid-stabilised basis, netprice 50 g = £13.48; A 3%, 50 g = £16.79. Label: 28Excipients none as listed in section 13.1.3DoseFor application to skin or scalp, apply 1% cream for up to30 minutes once daily, if necessary 3% cream can be usedunder medical supervisionNote At the end of contact time, use plenty of lukewarm (nothot) water to rinse off cream; soap may be used after thecream has been rinsed off; use shampoo before applyingcream to scalp and if necessary after cream has been rinsedoffPsorin c (LPC)Ointment, dithranol 0.11%, coal tar 1%, salicylic acid1.6%, net price 50 g = £9.22, 100 g = £18.44. Label: 28Excipients include beeswax, wool fatDoseFor application to skin up to twice daily