|
SKIN CAP
Skin-Cap spray is being heavily advertised
in the lay press and I am
encountering patients on a daily to weekly
basis asking about it.
Skin-Cap spray is produced in Madrid, Spain
by the Cheminova Corporation.
It has been used in Europe for about 10
years without any significant
reported side effects. It is FDA registered
in the U.S. to treat seborrheic
dermatitis and has been available in the
U.S., via mail order, for about 1
year. I have tried it on about 30 patients
and have achieved an
effectiveness rate of 100%, the majority
with total clearing of their
plaques in 3-6 weeks.I have used it side
by side in about 4 patients with
Dovonex and Temovate and it has been more
effective than either one alone
or the two in combination! I have also used
it in combination with PUVA,
etretinate, and methotrexate with excellent
results. (It cleared the
remaining resistant plaques in several patients
using methotrexate
without the need to increase the dose of
MTX, in fact we are considering
reducing the dose of MTX!!!!!!). There have
been rumors that the product
contains some form of steroid, but our chromotographic
investigations
reveal no steroid peaks, and, as mentioned,
it performs better than
Temovate. The listed ingredients are:([activated]zinc
pyrithione, sodium
lauryl sulphate, isopropyl myristate, and
propel 45 (propellant)).Of course,
I am a natural skeptic and I am happy to
announce that we have initated a
60 patient, double-blind, vehicle-controlled
study to properly evaluate the
effectiveness observed in our case reports.
(Our research is funded by an
unrestricted educational grant from Cheminova,
- we have no additional
conflicts of interest concerning the product).
-I am also giving a talk at
the 1997 American Academy of Dermatology
Annual Meeting[San
Francisco, March 21-26], Clinical Research
Symposium entitled "The
Successful, Safe and Highly Effective use
of Topical Zinc Pyrithione in the
Treatment of Psoriasis: A Report of 10 Cases".
(see page 81(second
column, time:3:24) of the 1997 program for
details). I've got some
tremendous before and after slides and I
encourage you to attend the
presentation and make comments/questions.
If possible, I will also
submit new case reports to the " Dermatology
Online Journal " for your
review. I sholud also mention that I have
recently become aware of
anecdotal reports that the spray, applied
twice per day, above the nail
matrix, effectively treats psoriatic nail
pitting(as the nail grows out)!!!!!!
We have decided to incorporate this into
our clinical study! I have also
used Skin-Cap to treat other pruritic/inflammatory
conditions including:
lichen planus, lichen simplex chronicus,
atopic derm, severe scalp seb
derm/sebopsoraisis, pityriasis rubra pilaris,
and notalgia paresthetica
with equally effective results!!!! It is
acting like a topical NSAID and very
strong anti-pruritic!! If additional testing
confirms the effectiveness of
this product, it truly could represent one
of the major advances in
dermatologic therapeutics since steroids.
Currently, most patients have to
pay for it out of pocket (~$39 for 100 grams,
-Dovonex retails for about
$150 per 100 grams) The nice thing about
the product is that it comes
with a money back guarantee, unlike most
Rx meds.
Charles E. Crutchfield III, M.D.
-----------------
I am very interested in this product as
well, and have been
happilysurprised to see that it seems to
work, when similar zinc
prythioneproducts, such as Head and Shoulders
shampoo does not seem to
have thiseffect. You mentioned chromatographic
studies. Is the company
willing to allow youaccess to records that
might disclose anything else
about the ingredientsin this product? Why
should this product have an
effect that other similarproducts do not?I
remain skeptical and am a bit
concerned about your enthusiasm. It isimportant
to maintain a
dispassionate approach to the testing of
anyproduct, especially if the
funding is from the company that makes it.
I must admit that your
inclusion of a telephone number in your
note soundsa bit like an
advertisement.As regards the comparison
to Dovonex, it is my experience
that a 100gm tubeof Dovonex goes a lot longer
way than a can of
Skin-Cap. Perhaps spray andointment applications
cannot directly be
compared. Additonally, incomparison to other
products containing similar
substances, Skin-Cap seemsgreatly over-priced.Having
said this, I look
forward to any well done study that might
give memore information about
whether this product has true therapeutic
value.
Jerry Eisner
----------------
My results parallel yours, and I am excited
that you are working
onobjectifying these anecdotal responses.
I agree Skin-Cap appears
tooutperform Temovate and Dovonex.
Mark Valentine
---------------
<< The listed ingredients are:([activated]zinc
pyrithione, sodium lauryl
sulphate, isopropyl myristate, and propel
45 (propellant)).>What are the
concentrations and what is the difference
between "activated"zinc
pyrithione and non-activated? Is activated
zinc pyrithione availableto
pharmacists for compounding?
Walter H. Wood, M.D.
-------------------
I called the toll free number given here
for "Skin-Cap" (888 6 SKIN CAP)
and got an answering machine message that
said it was for "dermatitis".
I
left a message, first as a dermatologist,
that I'd like to get some. There
was no response in 2 days time. I called
again as a layperson, again with
no response in 2 days. I then got the local
number and address in Miami
from the information operator for Cheminova
America. The first time I
called I got an answering machine message
that did noyt identify who or
whom I was calling, but said that I should
leave a message and they would
call back, which that have yet to do. The
local, Miami, number for
Cheminova is 305 825 7008; the local address
is 6073 NW 167th Street,
Miami FL 33015. I may try to visit if I
get an extra half hour to waste.
Michael Fetterman
----------------
The toll free number that I have been giving
to patients is
888-469-7546. They seem to be getting a
good response at this number.
I have now suggested this for 4 patients,
including a physician. All
have had dramatic responses. I'll be happy
when I see a controlled
study. It sounds too good to be all placebo/
moisturizing effect... I hope
it doesn't turn out to be just the latest
"fish oil."
Mark Crowe, MD
-----------------
Has anyone had any positive results with
Skin Cap spray? I recall
someearlier discussions on the list a few
weeks ago regarding this. I had
apsoriasis patient recently who has tried
PUVA, MTX, Dovonex,
topicalsteroids, etc. who elected to go
to Memphis to Dr. Rosenberg for
hisantimicrobial treatment (antibiotics
+ Nizoral + Nystatin). This
patientwas only minimally improved on the
regimen, and flared when he
tried todecrease his methotrexate dose.
When I spoke with Dr. Rosenberg
about this,he mentioned that he was seeing
good results with Skin Cap
spray - in factenough that his psoriasis
clinic had been cut in half due to
the success ofthis OTC product. I have started
a few patients on it but
have not yet seenthem back. It has to be
ordered through the mail from an
800#. Has anyoneelse had success or failure
with this product?
Mike Crowe, M.D.
----------------
I have been selling Skin Cap Spray in my
office for about two months.
Eithermy patients are conspiring to delude
me or this is the most
effective topicalproduct for psoriasis that
is available in the USA at this
time. Once theyfind out how effective it
is, patients never again complain
that theirinsurance won't pay for it. I
see patients regularly who had
disappointingresults with PUVA, Tegison,
and any topical you can name,
who are clearingdramatically with Skin Cap
alone. It is orders of
magnitude quicker thanphototherapy, and
I really think it ranks second
only behind methotrexate andcyclosporine
in effectiveness. I am usually a
skeptical therapist, andhave never in 20
years felt this degree of
enthusiasm for any new therapy,excepting
when Accutane became
available for acne......Try it if you don'tbelieve
me. I have no financial
interest in this product, except as adispensing
physician. In fact, I
anticipate losing a fair amount of incomefrom
patients who will no longer
need phototherapy. We sold a can one Fridayafternoon
to a 25 year old, a
15 year veteran of psoriasis therapy. She
waswaiting on our doorstep
Monday morning bouncing with excitement
and eager toshow us how the
Skin Cap was already working better than
everything she hadever tried
after just 60 hours. You can order the stuff
wholesale fromInterstate
Drug Exchange and save your patients the
hassle of getting it bymail, and
you can save them a few bucks in the process.
Mark Valentine
----------------
I've been reading the messages about this
stuff for quite some time, both
with amusement and bemusement.I just had
a patient come back from
Mexico, and his widespread psoriasis is
spectacularly better now that he's
using Skin Cap. He's certainly better then
the anthralin, Dovonex, and
topical steroids I've prescribed ever got
him! He's convinced it's this
product, and not the anthralin and Mexican
sun, that made him so much
better. We'll see.
Robert I. Rudolph, M.D., FACP
-------------------
I'd be interested to know the serum zinc
levels of people treated with
SkinCap - if there is enough inhaled or
taken up through the skin the serum
zinccould perhaps reach toxic levels.
Kevin C. Smith MD FRCPC
-------------------------
Hope I am not totally wrong, but the thing
is called Capsoft here. It is
produced by a rather small company in Hamburg.
About one year ago, they
had a big scene in a quite popular TV talk
show. There, the Capsoft fans
(and the company for sure) complained that
no medical center was ready
to perform clinical trials without getting
paid for that. On the other hand,
on my request they just sent one specimen,
so I couldn't make experiences
with this magic product. And who would recommend
the patients to buy a
rather expensive spray instead of prescribing
a conventional drug for
free?Hans J. KammlerJena, Germany, LazyEuropeI
have their address and
phone no. at the office and will post it
tomorrow if no one else posts it
sooner. The latest study I read was in The
Townsend Letter, an
alternative healing journal, and I believe
was written by a Vet. I can
getreprints or more info if anyone desires--I
have not used this product to
date.
Walter Yourchek
--------------------
Phone # 888-469-7546; also available thru
mail order house
IDE(Interstate Drug Exchange)
Jerry Bock
---------------
For those who have asked me about purchasing
Skin Cap:I buy it from IDE
Interstate, Inc. Their phone 1-800-666-8100,
or fax
themat1-800-433-3291.
Mark Valentine
---------------
I had my pharmacist mix up a number of different
formulations ofzinc
pyrithione. The next step is to see which
one works. If oneconsiders
azeleic acid: It only works if the mitochondria
arefuntioning. On can prove
this in bacterial cultures by adding sodiumazide
(which kills
mitochondria) If one adds sodium laurel
sulfate tothe bacteria nothing
happens. If one adds azeleic acid nothing
happens.If one adds them
together the bacteria should lyse (as they
do incultures not treated with
sodium azide) Again nothing happens. Thisshows
azeleic acid is actively
transported into the cells, sincestopping
the respiratory machinery stops
its action. I realize theazeleic acid analogy
is odd here but the take home
lesson is that thereis probably an interaction
between the zinc pyrithione
and one of theother ingredients, rather
than a pure zinc effect, just as
there is aninteraction between azeleic acid
and the sodium laurel sulfate.
Azeleicacid does nothing by itself. Zinc
pyrithione probably doesn't
either.I'll let you know when I figure it
out.
Haines Ely
-------------
According to the Psoriasis Foundation, the
original Skin Cap Spray
containeda steroid as well as ZNP. The steroid
has now been removed, and
the FDA isinvestigating the product further.
Please, you European
dermatologists, tellus more about the product.
Yelva Lynfield
--------------
The source I found was Progressive Labs
in Irving
Texas-1(800)527-9512.I called them today,
and their Spray is about $21
(for3.33 oz) to the Doc. The propellant
is butane. They stated that they
now have a U.S. version in an environmentally
safe pump bottle for about
$12.50 for 4 oz.,so I ordered some to try.
The article I read (with
impressive before and after pictures) was
in The Townsend Letter, Jan.
97, and written by Morton Walker, DPM, Stamford,
Conn. Anecdotally, I
saw a severe psoriatic this am who has been
using Skin Cap Spray to one
side of her body for two weeks and with
very impressive results--I'ma
sceptic, but will give it a fair evaluation,
and report back later.
Walter Yourchek
-------------------
I have a sample of "ecological"
Skin Cap from Cheminova U.K. Ltd.
Customerservice 800 61 spray (77729)It has
2 mg zinc pyrethrone and 1
mg methyl ethyl sodium sulfate per ml. "forrelief
of itching, irritation,
redness, flaking and scaling associated
withskin conditions." No mention
of psoriasis. No advice about how often
itshould be applied.
Kevin C. Smith MD FRCPC
------------------
I have yet to have any patients tell me
about it.However, another
dermatologist in the group had several patients
with good response to it,
and about twice that number who failed to
respond to it(so he tells me).A
lot us us will be at World Congress in Sydney,
where presumably we'll
hear about anything remarkably good and
new.
Michael Fetterman
------------------
While this is clearly belaboring the point,
I still want to keep talkingabout
Skin Cap. I too have now had several patients
return/call withglowing
reports, including two who were on systemic
therapies and are nowoff
them, and reportedly clear (in one case,
truly clear, confirmed on
myexam). I of course see my professional
career treating and
researchingpsoriasis vaporizing as Skin
Cap revolutionizes dermatology. A
couplequestions are raised:1. If this stuff
is really so good, and has been
available in Europefor a decade, why don't
European derms talk about this
stuff??? Do they know something we don't
about toxicity or efficacy, or is
this a conspiracy to deprive patients of
a drug which would cut their
practices by 50%? (see Dr. Crutchfield's
original post in which he states
it'seffective for LP, LSC, atopic derm,
seb derm, etc etc). I wish we could
get more feedback from Europe: anyone visiting
over their soon?2. If it
truly is this good, I believe this represents
a pharmacologicalparadigm
shift which would be equivalent to proving
that homeopathic remedies are
indeed effective. Mind-boggling to claim
that zinc pyrethione can do all of
this.3. It also would essentially negate
the unbelievable volume of
research into diseases such as psoriasis,
as it is hard to believe a simple
productlike this works through traditional
immunological or
microbiological mechanisms.Keep me in touch
with any comments or
experiences you all have with this stuff,
directly or via the list. Thanks!
Mark Ling, M.D., Ph.D.
--------------------
Mark, Our friend and semi-guru, Al Kligman,
says that everything works at
least once in dermatology. That may be what's
going on here. It is hard to
believethat ZPT in teensy concentrations
would not help dandruff (look
what happenedto the effectiveness of Head
& Shoulders when P&G lowered
the conc of ZPT)but would clear psoriasis.
Guy Webster
----------------
Mass spec or NMR would be dandy, but liquid
chromatography cheaper and
more readily available in any highschool
chem lab.I'd suspect something
like that, but even so, TCA in my hands
is no miracle drug.
Michael Fetterman
-------------------
Also have had a couple of psoriasis patients
come in with
"glowing"reports of clearing with
Skin-Cap-one in particular claimed to
have required mtx in the past, but now controlled
with Skin Cap. My
response was to provide a sample of DHSshampoo
with Zinc(label states
contains 2% ZNP) and to compare.Patienthas
not returned so I'm assuming
complete satisfaction.
Pierre Jaffe, MD
-------------------
Just opened my Jan-Feb 1997 issue of JGD(J
Geriatr
Dermatol1997;5(1):21-4) byCrutchfield et
al titled "The effective use of
topical zinc pyrthione inthe treatment of
psoriasis: a report of three
cases.Impressive photos depictingsignificant
and rapid improvement.
Possible mechanisms discussed.Is itthe zinc?
or is it the vehicle?is it the
combination of the above?A funread on a
gloomy saturday afternoon.
Pierre Jaffe, MD
-----------------
Would someone with patients responding to
Skin Cap please check a few
serum zinc levels and report back to us.
I wonder how much uptake the
patients are getting through the skin and
by inhalation. Hope there is no
heavy metal or arsenic in the spray (arsenic
of course works great for
psoriasis but hasfallen from favor because
of a poor long-term side effect
profile).Maybe look for adrenal suppression
too - that might pick up an
obscurecorticosteroid derivative that could
be missed if you didn't know
what tolook for on the mass spec / gas chromatography.
Kevin Smith
------------
When we discussed Skin-cap, I think I told
you that the ZNP bar is great
forseb derm, and that I started to recommend
it to psoriatics. About half
adozen of my chronic plaque psoriasis patient
have returned for followup
afterusing the bar for a month, and neither
the patients nor I was
impressed withits action except as a shampoo.
Yelva Lynfield, MD
-----------------
Read "The Effective Use of Topical
Zinc Pyrithione in the Treatment
ofPsoriasis: a Report of Three Cases"
published in The Journal of
GeriatricDermatology Jan/Feb 1997 by Chas.
Crutchfield et al from the
Univ. of MinnesotaDept. of Derm. In this
peer-reviewed journal they
describe dramatic successwith Skin Cap Spray
used b.i.d. on one side vs.
triamcinolone oint. or placeboointment on
the other. In one case, near
clearing occurred in 8 days. They havea
bigger study underway.Like
everyone else, I was surprised but this
product does seem
efficacious.They did acknowledge that other
ingrediants like the
propellant may be afactor.
Philip Hughes, M.D.
-------------------
I saw a patient today who I have been treating
for psoriasis for
severalmonths. He had failed to improve
on Dovonex or Temovate or a
combination ofboth and had many inflammatory,
eruptive, and pruritic
lesions all over thebody. I started him
on Tegison two months ago at a
low dose, 25 mgm daily,and raised the dose
to 25 mgm BID one month ago.
Two weeks ago, whilevisiting his psoriatic
aunt in Puerto Rico, he was
given a can of Skin Cap. He used it only
on the left leg below the knee. The
change was dramatic. The right leg had improved
no more than 25% on
Tegison whereas the left legwas completely
clear! I don't know how this
stuff works, but it seems towork better
than almost anything in our
current armamentarium.
Isaac Novick, MD
------------------
No personal or clinical experience with
Skin-Cap, but one of the other guys
in the group says he had several patients
show phenomenal clearing of
scalp psoriasis and seb derm with it..but
then found that like lots of other
products, was helpful for maybe an estimated
third of patients.
Michael Fetterman
------------------
May I hear from anyone who has seen a failure
to respond to Skin Cap?
Also, how about side effects? And success
in non-classic plaque
psoriasis? The manufacturer claims a success
rate of 85%, and I think
this may beaccurate, as I've seen four patients
with negligible benefit out
of the fortyor fifty patients who have tried
it in my practice, and it is
safe to assumethere are a few more failures
out there who have yet to
report back to me.No one has discovered
any side effects yet. I intend to
check zinc levels on any patients who are
steady users of large
quantitities of the stuff, buthaven't yet
had the opportunity. Anemia from
copper deficiency is the only theoretical
side effect I am aware of.I
haven't tried it on pustular or erythrodermic
cases yet. I have
anerythrodermic PRP patient and a refractory
lichen simplex chronicus
patientwho are trying it, but no reports
yet on results. I also don't know
how itperforms on palmoplantar areas yet.
Scalps respond well to it.
We've sent afew patients home with the pump-spray
formulation from
Progressive Labs tocompare with Skin-Cap,
but again too early for any
feedback.
Mark Valentine
--------------
I am delighted to see some feedback regarding
the Skin
Cap-typeformulation from Europe, where these
zinc pyrethione products
haveapparently been available for years.
I am still struggling with
theconcept of a product which is 85% effective,
according to a recent
post,yet which has not apparently swept
Europe by storm. I've given about
40or 50 of my most recent psoriasis patients
over the last month info
reSkin Cap so I presume in a month or two
I'll have more
substantiveexperience to report. More European
comments??
Mark Ling, M.D., Ph.D
.------------------
In Germany there is a product called "Capsoft
Regulativ-Spray".I don¥t
know if it is identic to Skin cap, but it
containsZink-Pyrithion like this.
Unfortunately I have no personally experiencewith
this product, but i read
about it in "Pso Magazin", the
journal ofa german psoriatic group. Several
psoriatics write about their badexperiances
with Capsoft. They describe it
as skin irritating.Dermatologists of the
University of Hamburg saw four
cases withpsoriasis pustulosa after use
of capsoft.
Andreas Eisenmann
---------------
It certainly isn't the zinc pyrithione in
Skin Cap which makes it work.
Ihave mixed up gels, liquids, and creams
with varying strengths of
ZPwithout much effect compared to the brand
name stuff. I deleted
themessage about the propellant of Skin
Cap spray so I couldn't ask
theauthor to e-mail me directly but I am
extremely curious. What is
it?Haines ElyI just got back from visiting
Vanderbilt Psoriasis Center.
Nurses statethat results with Skin Cap Spray
have been mixed but
generally positive.They state that many
patients have been more
impressed with a productcalled Apis. I am
getting more
information.Anybody heard of it?
Trey Truett, MD
-------------------
Isopropyl myristate is a synthetic oil found
in many cosmetics, and in fact
in some acne topicals, I think! I knew a
dermatologist who thought it to be
comedogenic.My money is on the sodium methyl
ethyl sulfate, or some
moiety derived from it, as being the (still)
secret ingredient. Can anyone
here comment on (potential) carcinogenicity
of alkyl sulfates ?
Michael Fetterman
----------------
This might help those of you who are running
literature searches:In my
handy Sigma chemical catalog (every derm
office should have one - mineis
kind of old - 1988) isopropyl myristate
is listed as: myristic acid
ethylester (a synonym is: ethyl myristate).Myristic
acid has a synonym:
tetradecanoic acid.In 1988 isopropyl myristate
sold for 24.70 / 100 g for
the 99%, and 24.00 /liter for the 95%. Certainly
much cheaper in bulk.
Kevin C. Smith MD FRCPC
---------------
Isopropyl myristate is "Liquid Wrench"
I think it is also a maincomponent
of WD40. It is the agent which induces perioral
dermatitis inmost
makeups sold as "oil free". What
a coup! Thank you sooo much forthis
information. Liquid wrench is a lot cheaper!
Haines ElyIndeed, I believe
there was a tabloid story a year or two
ago about WD40 for psoriasis. I
believe everything I read.
Haines Ely
------------
Don't you believe the zinc has anything
to do with it? Will you have
yourpatients put on Head & Shoulders
and spray with WD40? (is it really
trueabout WD40 or is this just another "urban"
myth?).
Eliot Mostow
-------------
As I mentioned in a previous note I've had
my pharmacist mix up
zincpyrithione in every vehicle I can think
of with only minimal results.
Imight add, only the solution with added
B6 had any effect.
Haines Ely
-------------
Hans, as far as I can see, FK-506 have very
different properties. FK-506
works as a topical agent on psoriasis. Cyclosporin
doesn'teven work when
injected intralesionally in Psoriasis.
Rhett Drugge, M.D.
-------------------
After noting the possible association between
Skin-Cap and WD40, one of
our Rheumatologists told me that many of
his arthritis patients spray
WD40 on an inflammed joint and get temporary
relief of pain. He believes
it works but also thinks that it may have
caused one case of neuropathy.
Today, I recieved my first mass mailing
for ordering Skin-Cap. The need
for credible data on safety and efficacy
is clear!
John Melski MD
-------------
I hope it is forthcoming. However, I was
able to speak with someone at
theFDA dermatology division Thursday, and
she wasn't able to tell me
much. Iasked if I might be kept abreast
of any investigation into the
safety of SkinCap. Apparently it is strictly
against FDA regulations
torelease any information whatsoever about
investigations or new
drugapplications that are pending. She was
categorically unable to even
discloseif Skin Cap currently has any applications
filed with the FDA. My
concernsabout patient safety seemed to not
count for much in the FDA
scheme ofthings. She suggested I contact
the office on Advertising and
Communicationsand lodge a complaint because
of the illegal advertising
for psoriasiswithout an FDA indication.
This I am not prepared to do.
Knowing how theFDA works, they would probably
determine that it was
entirely safe, and thenproceed to confiscate
all the product, since they
value form over function bya 10 to 1 margin.Meanwhile,
my first feedback
(one patient only) on the zinc pyrithione
sprayfrom Progressive Labs in
Texas is that it is not effective, at least
whencompared with Skin Cap.
This is as Haines predicted. I also saw
threepsoriasis patients yesterday
who, much to my dismay, failed to see muchbenefit
from Skin Cap.
Mark Valentine
-----------------
I recently had a patient in with psoriasis
resistant to topical therapies
but as it was not too severe she did not
want to try anything else...yes, she
was in last week clear, using skin cap...as
her lesions did not respond to
temovate it makes me wonder, despite a biopsy
consistent with psoriasis,
if we are not dealing with more than one
cause of psoriasis, even though
the clinical/histological pictures are the
same...so that type 2 for
example, may be steroid/mtx/etc resistant
but skin cap responsive... any
comments?...
Steve Emmet
--------
Well, I've finally bowed to my own curiosity
and started to use Skin Cap
Spray. Just a few patients, paired comparisons
with one side being
treated in the usual fasion for that patient,
and the other with Skin
Cap...very informal, careful observations
and phone calls.Preliminary
thoughts...impressive results. Some of the
" light patients " with
resistant areas have cleared. The untreated
areas, no change. Patients on
Mtx with some residual plaques...cleared
on the treated sides, no change on
the other. No experience yet with nail problems,
looking for more date on
scalp psoriasis.Continuing to study, more
information in a few weeks.
Elliot Puritz
-------------
Skin Cap seems to be working ok here in
south hemisphere,too. One 75 yr
oldpatient with widespread psoriasis had
some control,before,but taking
manydrugs,etc. Like magic, his only 15 days
applying S cap has lead him to
morethan 50% clearing - we are all amazed!
He complains of the price, but
he'svery happy.Hope you don't find any bad
thing about this product.
George Leal
------------
Dear all,one of my psoriatic patients brought
me today the insert of SKIN
CAP, newlymarketed in Brazil (supposedly
the same). It says- "S Cap is a
modernproduct, made of A TENSOACTIVE (METHYL
ETHYL SODIUM
SULPHATE) THAT HASANTISEPTIC AND KERATOLYTIC
PROPERTIES
(ELIMINATES EXCESS OF EPIDERMIS IN ALARGER
THAN NORMAL SCALE). THIS
TENSOACTIVE RECEIVES A POTENCIALIZATIONFROM
ZINC PIRITHIONE, that
reforces ist antibacterial and antifungal
actions(alas , decisive for the
control of the affection).I am doing a little
research on methyl ethyl
sodium sulphate, but so farunproductive.
George Leal
-------------
I have received the following communication
from Richard Faiola,
M.D.,Medical Director of "Noble Products,
Inc." a Distributor of Skin Cap in
theU.S. According to the letterhead he is
a family practice doctor
andmanaging partner of L.G. Steck Memorial
Clinic in Chehalis, WA.
Subj: Re: Skin CapDate: 97-03-10 02:52:57
From: FaiolaR@localaccess.com (Richard Faiola)
To: WHWoodII@aol.com
Per the manufact. they have appropriate
registration with FDA and
anational drug identification # (its on
the package). FDA "approval" of
aspecific product like SkinCap is not required
and has neither been
soughtnor granted. Its ingredients are from
among those for which the
FDA haseither granted a "generally
recognized as safe" designation or
has
apermissive "monograph" on. In
other words, manufactures are free to
usethe ingredients of Skin Cap without specific
additional FDA review. It
isan OTC product. It does not require New
Drug Application,
norsafety/efficacy data when labeled for
the cosmetic indications
of"Dandruff" and "Seborrhea."
They can not label it for the
medicalindication of "psoriasis"
The FDA removed "the heartbreak of
psoriasis"from the cosmetic to the
medical several years ago. That does
not mean Ican not share with me colleagues
its utility for symptoms
associated withthat disease, but our consumer
advertising will be careful
to make clearthat it is for the symptoms
of "itching, flaking,
inflammation" associatedwith various
skin disorders. A double blind
placebo controlled study isbeing completed
in now, by an American
researcher, independent of thecompany. I
believe, but have not first hand
confirmation that the resultsare confirmatory.
The researcher had a bit
on the Internet 2 or 3 weeksago, responding
to a question, and reported the
results as promising andalso that he expected
to be presenting to the
Derm meeting in SanDiego. The company sponsored
some studies in Latin
America--I have reviewed them. They showed
good results, but they do not
meet my own or usual scientificstandards.
The active ingredients are
those listed in my letter. ZincPyrithione,
sodium laurel sulfate (an
irritative detergent in toothpasteand several
other hygiene products.
There is some alcohol and otherpresumed
inactive excipients and
propellants. The zinc portion is, ofcourse,
the same as in "Head and
Shoulders." I personally believe the
SLSfacilitates the absorption of the
zinc, while acting as a directkeritolytic
(SLS has been shown to permit
the dangerous absorption ofnickel transdermally
in foundry workers, no
known studies directly on zinc,but then
unlike nickel zinc is a desirable
nutrient). Bottom line: Thestuff is relatively
cheap compared to some of
our other options, looks likeit should be
reasonably safe, and IT WORKS.
About 50,000 persons are orhave used it
in the US
----------
i have a very cooperative japanese patient
with basically total body
psoriasis, untreated, (mentioned as i don't
know if japanese skin may
respond differently from caucasian)...who
used skin cap bid on one arm and
temovate cream bid on the rest of his body...at
three weeks of temovate
and two weeks of skin cap, the skin cap
was clearly better, with flatter
plaques, less redness, less itching....
Steven D. Emmet, M.D.
---------------
Another glowing report. 55 year old with
25-30% surface area
psoriasissince l959, recalcitrant to many
rx's in the past including PUVA.
CLEARafter one month, and 6 cans, of Skin
Cap aerosol. No kidding.IWe will
see if it will be the second non-prescription
drug put on theformulary. The
first being Unibase.
Diane D Thaler
---------------
A few weeks ago I suggested to a half-dozen
psoriasis patients that they
tryLiquid Wrench on their psoriasis ( eg.
Wal-Mart, $4.99, mostly
isopropylmyristate) and the first one came
back yesterday -- happy lady:
not amiracle, but considerably improved.
Kevin C. Smith MD FRCPC
--------------------
Another glowing report for Skin cap spray
here also........56 yo
recalcitrantpsoriatic who we have been keeping
maintained with modified
Goeckermantherapy, topical steroids and
dovonex. One week and two
bottles of skin capspray and she is TOTALLY
CLEAR...........I am impressed!I
have just place 5 more patients on it and
will report later.
Jeff Marmelzat
-----------------
... personal experience. I've given SC to
between 50 and 100 patientsover
the last two months. My experience is that
it is an unbelievablyeffective
drug for a SUBSET of patients, perhaps 50%
in my estimation.They get
dramatic clearing, often within a few days
of starting, andwithin a month
generally are to the point where it's tough
to see wherethe psoriasis used
to be. Phenomenal. Others simply don't respond,
or evendevelop a
significant irritant dermatitis. I worry
about the stuff a lot,since I don't
believe it's just another Head and Shoulders,
but it is soeffective that at
least until someone demonstrates potential
toxicity itis hard for me to
justify not using it. Still, I'm keeping
my ears open.The demand is so great
now that the Nova folks are 4 weeks back
ordered.Finally, I had some
patients try a "knock-off" in
a pump spray bottle. Wassupposed to be just
as good as SC. It was 100% ineffective,
a totalfailure. BTW, the local
distributor, a former patient, apparently
admittedto one of my current
patients who had tried the knock off, that
he hadbeen forced to start using
"real" SC again to control his
psoriasis
Mark Ling, M.D., Ph.D.
--------------------
I understand that there is good efficacy
and tolerability in early
trialswith calcipotriol (know as calcipotriene
in the US) in an isopropyl
myristatebase for scalp psoriasis.Isopropyl
myristate is of course the
same stuff found in Skin Cap. It is saidto
greatly enhance permeability of
the scalp to calcipotriol.
Kevin C. Smith MD FRCPC
----------------------
the steroid rumor has surfaced with Skin-Cap
repeatedly: I think
thearchives may contain prior discussion.
Dr. Crutchfield at U. Minn. has
hadit analzyed with GC and clearly states
there is no steroid peak
identifiable. That of course does not mean
that Skin-Cap might not cause
striae.
Mark Ling, M.D., Ph.D.
--------------------
For those who may have missed out on the
earlier discussion, Skin Cap is
anOTC spray product that contains zinc pyrathione
(the stuff in Head
&Shoulders shampoo) in an organic base
that is largely isopropyl
myristate.Apparently this base is important
for allowing penetration of
the zinc tothe deeper layers of the epidermis.
This product is
manufactured byCheminova International Laboratories
and distributed in
via the Internet byNet Nova Pharmaceuticals
(http://www.clearskin.com/).The spray works
dramatically in somewhat
more than half of patients withplaque-type
psoriasis when sprayed on bid.
An interesting facet of it isthat the severity
of the problem doesn't seem
too much of a factor inwhether someone will
be good responder or not,
meaning it may work on someof your severe
longstanding problem
psoriasis patients that don't respondwell
to much else.I know it sounds
like a con game, but it is true. When it
works it's betterthan Temovate
(works faster too) and (so far) doesn't
seem to have thetachyphylaxis
problems of topical steroids.
It is cheaper to buy in largequantities,
so if you are going to start
recommending it, you might do yourpatients
a favor by being their volume
purchaser and reselling it to themat near
cost.The toxicity of this
preparation has not yet been studied very
well,although Zinc is one of the
least toxic metals (compared with Cadmium,Mercury,
Arsenic, etc.), and
has even been used orally to treat a number
ofdiseases in the past
including Wilson's disease [1-3], cirrhosis
[4], andsickle cell anemia [5] to
name a few. Dermatological diseases that
havebeen treated with it include
acne (doesn't really work very well) [6-10],chronic
mucocutaneous
candidiasis [11] and interestingly enough,
psoriasis[12]. Before you all run
out and put your psoriasis patients on oral
zincsulfate, please note that
this double-blind trial with 25 patients
wasunsuccessful. 600 mg/day of
oral zinc sulfate is fairly well tolerated
withmainly GI side effects, so I
am assuming for the moment at least that
thisSkin Cap stuff is not going
to be too toxic. As well as it works, it's
notgoing to go away unless it
turns out to be a lot more toxic than Ianticipate,
however. Somehow this
got by the FDA, I suppose because zinc pyrathione
had been around and
shown to be safe (Head & Shoulders shampoo).However
the Cheminova base
is a whole 'nother ballgame and turns zincpyrathione
into a sure 'nuff
potent topical drug. Stay tuned.
References:
1. Hartard C, Kunze K: Pregnancy in a patient
with Wilson's
diseasetreated with D-penicillamine and
zinc sulfate. A case report and
review ofthe literature. European Neurology
34(6):337-40, 1994.
2. Heckmann JM, Eastman RW, De Villiers
JC, et al.: Wilson's
disease:neurological and magnetic resonance
imaging improvement on zinc
treatment[letter]. Journal of Neurology,
Neurosurgery & Psychiatry
57(10):1273-4,1994.
3. Shimon I, Moses B, Sela BA, et al.: Hemolytic
episode in a
patientwith Wilson's disease treated with
zinc. Israel Journal of Medical
Sciences29(10):646-7, 1993.
4. Marchesini G, Fabbri A, Bianchi G, et
al.: Zinc supplementationand
amino acid-nitrogen metabolism in patients
with advanced
cirrhosis.Hepatology 23(5):1084-92, 1996.
5. Gupta VL, Chaubey BS: Efficacy of zinc
therapy in prevention
ofcrisis in sickle cell anemia: a double
blind, randomized
controlledclinical trial. Journal of the
Association of Physicians of
India43(7):467-9, 1995.
6. Cunliffe WJ, Burke B, Dodman B, et al.:
A double-blind trial of azinc
sulphate/citrate complex and tetracycline
in the treatment of
acnevulgaris. British Journal of Dermatology
101(3):321-5, 1979.
7. Michaelsson G: Oral zinc in acne. Acta
Dermato-Venereologica.Supplementum Suppl(89):87-93,
1980.
8. Orris L, Shalita AR, Sibulkin D, et al.:
Oral zinc therapy ofacne.
Absorption and clinical effect. Archives
of Dermatology114(7):1018-20,
1978.
9. Weimar VM, Puhl SC, Smith WH, et al.:
Zinc sulfate in acnevulgaris.
Archives of Dermatology 114(12):1776-8,
1978.
10. Weismann K, Wadskov S, Sondergaard J:
Oral zinc sulphate
therapyfor acne vulgaris. Acta Dermato-Venereologica
57(4):357-60,
1977.
11. Polizzi B, Origgi L, Zuccaro G, et al.:
Case report:
successfultreatment with cimetidine and
zinc sulphate in chronic
mucocutaneouscandidiasis. American Journal
of the Medical Sciences
311(4):189-90, 1996.
12. Burrows NP, Turnbull AJ, Punchard NA,
et al.: A trial of oral
zincsupplementation in psoriasis. Cutis
54(2):117-8, 1994.
Mark Naylor, M.D.
------------------
this is an updated report. The patient is
the "elevated sgpt
psoriasispatient",presented in these
lists weeks ago, to whom I started
SKIN CAPSPRAY. I AM COMPLETELY AMAZED!!!!!!
ASTONISHED! - with just one
week of thespray use, he GOT RID OFF ALL
HIS LESIONS, SCALP AND BODY!!!!
I saw himtoday,he is completely "clean",
and we are all very happy! And he
hasn'tapplied it for 2 weeks.We are also
happy he doesn/t have to take Mtx
(or anything else),so far.I hope this thing
doesn't cause tachyphylaxis,or
anything else, for it wasfantastic. I have
some other patients using it,yet
to come back.Thanks
George Leal
Dear Drs. Crutchfield,
I have had an excellent success with the
few patients to whom I haverx
Skin Cap Spray. Now I ask you, once achieved
this result, how do
youprescribe maintenance therapy? I have
told them to apply the spray
once aweek, in the places that had the lesions
before. Have you seen
tachyphilaxis?
George Leal
--------------
Skin cap spray has produced an acneiform
eruption in several of my
patients whenused on the face or neck. Not
surprising after all the talk
about commoningredient in WD 40, Liquid
Wrench and Skin Cap Spray.
Philip Hughes, M.D.
--------------
Diane - there is a primary irritant contact
dermatitis that occurs from
timeto time with skin cap - I've seen it
in one caregiver who developed
itwithin 48 hrs on forearms where some of
the mist settled - cured by
usinglong sleeves and greater care.Other
notes on Skin Cap.Local WalMart
now has it behind the counter - too much
stock "shrinkage"from folks
taking a five-finger discount. How many
little cans could you fitin *your*
pocket or purse? The sign of a successful
product, I guess.Helpful
money-saving hint. Spray a bit on a china
saucer, use a finger toapply dabs
quickly to areas you don't want to spray
( e.g. spots on face orguttate
lesions or even the returning spots when
the disease wants to comeback).
If worried about contact, wrap applying
finger in SaranWrap then dipand
dab.I have now treated three DLEs (BID x
2-4 days then 1/day x a few days
thewait and watch) and two non-specific
intertrigos in males (single
spraytwicw a week only - done in the office
for good control and so I can
watchcarefully the results.
Bill Danby
--------------
I now have one patient with extensive psoriasis
who is using Skin Cap
insome areas & Liquid Wrench in others.
She feels there is some efficacy
ofLiquid Wrench & she reports that both
products have an identical feel
onthe skin. However, the Skin Cap appears
to be the more effective
product.
Jerry Bock
-----------
I have had a number of patients develop
acneiform eruptions (acne
venenata) from Skin Cap Spray, which isn't
surprising.
Philip Hughes, M.D.
-----------------
Just an update on my experience with SkinCap.
I stock it so as to provide
my patients with their first can ( charge
$30). I have arranged for a local
pharmacy to carry it and ask pts to get
more there. I explain that I do not
know why it works, and despite lack of knowledge
about all the
ingredients, have not heard any significant
comments from those on this
list about serious side effects.The patients
are uniformly reporting
favorable effects on scalp, body and hands.
I have not seen any significant
side effects, except for a little dryness
in some cases.
Jerry Eisner
--------------
I've been following the Skin Cap discussions
with interest, and
havepurchased some and am now having some
patients use it. These are
allpatients I've seen for years, and who
have resistant psoriasis.
Theseare the kind of patients we all have
a lot of: good patients who
havetried many therapies (of all sorts,
including the "big guns"), and
whoremain active, and difficult to treat.I
just got a marvelous letter from
a young man with very widespreadpsoriasis
who tells me his psoriasis is
better now (after one week) oftherapy, then
ever before.I asked him to
come into the office, and guess what: he's
spectacularly better. I have
never seen any response in any psoriasis
patient like this in 22 years of
practice! Ican't wait to hear from other
patients. I'll let the group know
about the follow-up. As for now I stand
amazedand delighted!Had another
lady come into the office to show me the
effects of Skin Capon her
widespread and very chronic scalp psoriasis
(which has notresponded well
to topical steroids, tars, acid preps, etc.
over theyears).After 5 days of
use she is clinically almost totally clear
of PSO. She and I are pleased
andastonished.
Robert I. Rudolph, M.D.
-------------------
Has anyone seen (not heard of) any significant
untoward reaction that
they believe is more likely than not due
to Skin Cap? I have not seen any.
Jerry Eisner >>So far naught but an
occasional complaint of stinging in
over 225 canssold.....One of my most impressive
responses: A man with
severe pustular psoriasis ofthe hands, with
marked swelling, secondary
anonychia, and inability to evenbutton a
shirt or zip a zipper, had been
completely disabled by his diseasefor at
least 8 years, and essentially
unresponsive to MTX, PUVA, topicalsteroids,
and Dovonex. Symptoms
reduced to mild peeling with two cans ofSkin
Cap......
Mark Valentine
--------------
In response to the question of adverse reactions
to Skin Cap: We (I and
Drs. Lewis and Zelickson) are currently
conducting a 60 patient double
blind, vehicle controlled study on the treatment
of topical zinc pyrithione
spray (skin cap) for psoriasis. We published
the results of pilot studies in
the Jan/Feb issue of the J. of Geriatric
Dermatology (they accidentally
reversed the before and after photos-so
please "reverse them back" if
you
read the article), and recently spoke at
the clinical research symposium of
the American Academy of Dermatology (San
Francisco, 1997) and
presented at the Society of Investigative
Dermatology (Washington DC,
1997) and have a published report that can
be viewed on the Dermatology
Online Journal;web address:
http://matrix.ucdavis.edu/DOJvol3num1/zinc/zinc.html
Essentially, in our
clinical experience of well over 100 patients,
in about 5-10% of patients
we have seen a very mild and transient flare
of the psoriasis that falls off
in the first 1-3 days. I warn my patients
about this and tell them to treat
through it, unless it becomes severe (which
it has not, as of yet). About
20% of patients complain of dryness and/or
irritation. For the dryness, I
recommend a moisturizer of choice about
1 hour after applying the
Skin-Cap. For moderate to severe irritation,
I recommend just QD
applications. I have had 1 or 2 clinical
patients stop using due to
irritation. None of the study participants
have left the study for adverse
reaction reasons. There is a post healing
erythema that is replaced by
post-inflammatory pigmentation that fades
with time. Although I have
not personally seen it, I have heard of
reports of tachyphylaxis-like
reactions from colleagues. Additionally,
there have been reports by users
on the psoriasis support groups of what
they term as a "rebellious
psoriasis", i.e. red papules and possibly
pustules arising at the periphery
of healing plaques. The only explanation
that I have for this, (since I have
not personally seen it), is a koebnerization
reaction secondary to
irritation of normal skin included in the
"treatment spray area". I have
had
a few patients who have significant improvement
to a point, but don't
totally clear. The next time this happens
I'll be tempted to try
combination therapy (add a potent steroid
or Dovonex, or both). I have not
tried combination therapy to date, but this
may be a good group to try it
on. Has anyone else tried combination therapy?
I have seen a small group
of patients who, with compliant BID applications,
don't start to respond
until week 5 or 6. For this reason, I don't
consider anyone a treatment
failure unless they have compliantly adhered
to a BID application for 8
weeks.We'll have more to say as we conclude
the study (August 1997)and
analyze the results. We are also looking
at the treatment of psoriatic
nails by BID applications above the nail
matrix, and also looking at
periodic, treatments (once or twice per
week) to cleared "trouble areas"
to reduce or prevent future flares. We are
also initiating cellular studies
with Mark Pittelkow at the Mayo Clinic to
get a better understanding of
the cellular mechanisms of action.What are
others experience with the
tachyphylaxis/rebellious reactions??? I
donít know if there is a "safe"
limit to the surface area that can be treated.
Cost seems to be the
limiting factor at this point.Has anyone
had any luck treating palm/plantar
pustular psoriasis?? I've had a good response
in 1 patient of 2, with a 3rd
patient being evaluated currently.What about
keratoderma
blennorrhagicum? (I haven't tried it on
this condition, yet). I have also
used it very successfully on lichen planus:
4 of 4 patients with near to
total clearing, with a 5th patient being
evaluated currently.I understand
that there will be several other "knock-off"
zinc pyrithione sprays
available soon. I'm happy to hear of this,
especially if they work.
Competition is good, and hopefully will
drive the price down, a complaint I
constantly hear from my patients who have
to pay the OTC price of $30-40
a can, and who can easily go through several
cans to gain control.I enjoy
reading about the experiences of others,
good and bad, of this interesting
treatment. Iíll share additional
information concerning our research,
with the group, when appropriate.
Charles Crutchfield III, MD
------------------------
The isopropyl myristate of Skin-Cap is a
proven comedogen. However that
does not make it "the mechanism".
It is fairly well proven, I think, that
the
major route of penetration of topical agents
is via the follicles however.If
we can assert that zinc pyrithione under
occlusion is capable of this
dramatic result in psorisis and other inflammatory
dermatoses, then it
would be a cheap study to see if topical
zinc pyrithione and other
comedogens or occlusive dressings do the
job.I doubt it.Certainly the
isopropyl myristate content along is basis
to avoid acne prome regions.
Michael Fetterman
--------------
I have been using Skin Cap for several months
and so far the results
areremarkable. In my opinion Skin Cap blocks
a step very high up in the
cascadeof events that gives rise to a psoriatic
plaque and thereby stops
the wholeprocess cold. All the other medications
we use act to suppress
psoriasis atthe end of the cascade. When
we find out how it works we
will probablyuncover something very basic
in the pathogenesis of
psoriasis.I order Skin Cap in bulk from
Acu-Derm and sell it to patients at
cost. Itell them that if the medication
works they can order it
themselves. Thetoll-free number is on the
box. Do I feel bad about giving
patients a medication of whose mode of action
I amignorant? No, because
the vast majority obtain quick and complete
relieffrom a bad disease that
I have not been able to give them using
variousexpensive medications all
of which have their own set of side effects.
Idon't think I could, in good
conscience, start a psoriatic patient onTegison,
Methotrexate, PUVA,
Cyclosporin, Hydroxyurea, or even UVB withouttrying
Skin Cap first.
Isaac Novick, MD
------------------
I just wanted to alert the members of some
information I became aware
of last night. According to an article published
in De Telegraaf, May 29,
1997, the Minisrty of Health of the Netherlands
pulled Skin-Cap off the
market because it was discovered to contain
a potent steroid. Early in
1996, Skin-Cap was banned from the Austrian
market because if was
found to contain high levels of triamcinalone
(~0.5%). I received the
Austrian information from a posting to a
psoriasis support group by the
Canadian Distributor of Skin-Cap (her name
is Patricia Cross, email
address:pcross@rideau.carleton.ca). According
to an official cheminova
company statement, a few lots were accidentally
"contaminated" with
triamcinalone. They were unsure how this
happened and plan to try to
reintroduce it back into the Austrian market
sometime in the future.
Concerning the Netherlands- Recently, a
high ranking official at the
National Psoriasis foundation did telephone
and speak with an official at
the Ministry of Health in the Netherlands
who was involved with the case
and was told that the steroid found was
clobetasol proprionate!We are
currently finishing a 60 patient, double
blind, vehicle controlled study on
the use of topical zinc pyrithione (s. cap)
to treat psoriasis. Naturally, we
were concerned and very interested in this
development. Because of early
rumors of steroids(which recently went fom
rumor to fact by the
cheminova/Canadian statement) , we did test
the study samples for
triamcinalone (HPLC and nmr) and found NO
triamcinalone. It is my
understanding that it is very difficult
to detect any random steroid- it
must be looked for specifically, a time
consumimg and costly fishing
expedition if one is to be thorough, which
certainly was beyond the scope
of our study. The company stands by its
statement that U.S. Skin-Cap
contains only: zinc pyrithione, isopropyl
mysristae, propel 45 (iso-butane)
and sodium-lauryl-sulphate (although initally
they claimed that the
sodium-lauryl-sulphate was "sodium-methyl-ethyl-sulphate",
a situation
which is still confusing. I have sent a
letter (fax) to Cheminova today
(June 13, 1997) asking for an explanation
of the Netherlands events and
to, once again, confirm that the U.S. product
does not contain steroids of
any kind. Has anyone seen immediate blanching,
steroid atrophy, or
tachyphylaxis-like reactions in s. cap patients?
I have not, (but I have
heard of a few tachy reactions).Does anyone
else have any insight into this
interesting situation? I will keep the group
updated on the response and
any additional information that I come across.
We will now try to check
for clobetasol proprionate, as I am sure
others (FDA, etc) will also.
Charles Crutchfield
-----------
I'm sure all dermatologists have prescribed
triamcinolone and clobetasol
for a dozen years or more in the hopes of
containing and trying to "cure"
psoriasis. Has it ever worked? Has it ever
worked like Skin-Cap? Never!I
have, as we speak, discharged 14 psoriasis
patients, some of whom have
had their ailment for more than 30 years.
I either have discharged them, or
they call me and tell me they are cured.
And they thank me and some say
they pray for me. And these same patients
have used, on and off, all the
potent steroid creams, ointments, lotions,
and sprays, including
clobetasol (Temovate -- cream, E-cream,
ointment, gel and scalp
application). With little, if any, significant
results.So if there are a few
"drops" of clobetasol in one (or
more) of these sprays, how do you account
for the almost immediate relief -- subjective
and objective -- of
psoriatic patches? And thick scalp psoriasis?
And you all have used
clobetasol, haven't you? Have you gotten
similar results?There has to be
another answer. Meanwhile, I'm happy that
many of my patients are happy
with their results.
Jerry Litt.
------------------
I can only say that I have never had the
results with clobetasol,
Dovonex,methotrexate, whatever, that I am
seeing with Skin Cap.I have
used it successfully on dyshidrotic eczema
of the hands that wouldnot
respond to clobetasol.I most recently am
using it on an elderly woman
with intertrigenouserosive and pustular
psoriasis. I believe the acute
episode was triggeredby her diabetes,indwelling
urinary catheter with
infection, and possibly yeast. She wasinsevere
pain from the erosions and
we placed her in the hospital. I amapplying
Skin Cap once daily in this
area. I am also using Tegison 25mg,IVCipro,
oral Diflucan, and topical
Desonide (once daily). Within 24 hoursher
pain was resolved. Within 48
hours her pustules are resolving and theerythema
fading. Whatever is in
this stuff, the benefits outweigh therisksso
far. The patient thinks I
perform miracles. Keep us posted.
Jerry Eisner
------------------
I agree with Drs. Litt and Rudolph, I've
never seen anything work like
skin-cap. Including our study, Iv'e used
it in well over 100 patients with
only a handful of failures. I've used it
against psoriasis (monotherapy
and combination therapy with the residual
plaques of MTX and PUVA),
lichen planus (ESPECIALLY LP-see previous
posting), atopic dermat
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