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I have a patient with long standing eczema; palmo plantar. Currently with some keratitis, plus friable & fissured areas.

Her GP has just prescribed propylene glycol foot soaks. On examination of the (large) bottle, it has no % content on the label, and she has had no usage instruction.

This is the first time I've heard of it's use in this manner, and I've told her to hang fire using it until I can find out more.

Any help welcome.

 

PG is often used as a penetration enhancer in meds and is also one of the ingredients in the urea & SA preparation for treatment of seborrheic dermatitis. However, there have been reports of allergic contact dermatitis to PG, so I would recommend a patch test prior to regular application, particulalry if high concentration.

You may find this Derm article interesting;
http://www.the-dermatologist.com/content/focus-propylene-glycol


Can`t research a great deal at the moment as my left hand is out of action (spent more than a few hours in A&E following a `slip` with my GLOBAL knife today....:butcher:)

Bel

 

Thanks for that; have read the article you suggested prior to posting. However, it's not been prescribed in conjunction with anything else, just on its own, and the concentration is not on the labelling; the patient was going to use it as is, as a foot soak. I cannot understand the prescribing rationale here.

 

If a pt is unsure of why they have been prescribed or how to use any medicament, they should go back to the prescriber and request clear directions and an explanation of the mode of action. Personally, I wouldn't recommend PG for any dermatitis, the eczema society do not recommend it and, as you know, it is documented as a known sensitizer for irritant and allergic contact dermatitis.

 

Surely palmo/plantar eczema is dyshidrosis, my fave disease.
This is the single most misdiagnosed condition by MDs, andPG, yes, enhancer, treatment no!
I would like to ask for a few questions to ascertain her fungal status.
The more I research dyshidrosis, (up to 60 patients so far, and 50 cures, 3 fails, and others under treatment)the more I find non disseminated candidiasis...easy cure is 28 days of 2million units daily Nystatin. 5 drops taken 4 times a day with food. If not, Toctino, which you can get in the UK, not in USA or Australia. Or ratio'd vitamin A. A 90 day course of treatment.
It is not in the skin, this is just the manifestation of the histamine/allergic reaction. A mega form of the "Id reaction".