Shaking up traditional thinking about dermatologic therapies

As a dermatologist for 27 years, Norman Levine, M.D., professor of dermatology, University of Arizona College of Medicine, Tucson, and editorial advisor to Dermatology Times, has gathered new insights from clinical experience, reference books, professional meetings and reviews of treatment modalities.

Take rosacea therapy, for example. Dr. Levine has found metronidazole to be only modestly useful in active disease and that it actually works better in maintaining remission. Alternatives to consider using, he said, include azelaic acid.

Dr. Levine also compares a number of treatments for atopic dermatitis. While tacrolimus (Protopic, Fujisawa) is a reasonable corticosteroid substitute, the expense may be a limiting factor. He concludes that although the drug is fairly effective in treating atopic dermatitis, it is difficult to use in widespread disease and does not provide a major improvement over mid-potency topical corticosteroids.