Thursday, October 7, 2010

I was supposed to put steroids on her?

Got Voov's nails clipped tonight, without too much strife. Just had to distract her with a few books.

She had an appointment today with the dermatologist, who determined that we could scale back on the "Derma-Smoothe" liniment that we'd been using. Derma-Smoothe is 0.01% fluocinolone acetonide in a liquid base, with the consistency of grapeseed oil. Here's the joke--I thought her skin was getting better by itself, because I was just putting moisturizer on Voov on the nights I have her--and then Hidden B tells me that no, Voov is getting better because she's been slathering her all over with Derma-Smoothe on the nights she has her.

I know what fluocinolone acetonide is, because I have it at 0.05% in a thick ointment base, aka Lidex. It's the "strong" steroid I use, probably too casually, to control my flares. It truly is amazing how doctors will prescribe a therapeutic meant to be applied in a certain controlled manner, and then the patient gets home and forgets the details, or perhaps was never told exactly how to use it or how dangerous it is. With babies the parents have to communicate too. So there's this powerful steroid that 1) I don't use at all and 2) my wife puts all over Voov on alternate nights.

Maybe we've stumbled on the ideal dosage schedule.

Anyway, she's doing well now, so Derma-Smoothe is to be used only for limited stretches on flares.

I'd like to see the day there is a therapeutic or two that REALLY controls eczema and doesn't have the side effects of steroids. (I might at some point get into steroid chemistry and what they're actually doing when you use them.) Novartis, who sells pimecrolimus, and Astellas, which makes tacrolimus, would like you to think the problem is solved, but not for me it isn't. I've tried both. Pimecrolimus did bugger-all, and tacrolimus did bugger-all and gave me an otherworldly headache.

However, pimecrolimus and tacrolimus are in the general direction I would like to move eczema research. They're both immune-suppressive drugs that turn off a specific signaling pathway in T cells (that's one thing they do, at least; drugs never do just one thing). What do T cells have to do with eczema? (Gonna look into that.) What other microbial chemicals are out there in the soil? (Tacrolimus: discovered in Japanese soil bacterium.) Are there FDA-approved drugs already on the market that suppress eczema as a "side effect"? Let's get the right scientists on the job and give them the funding to get results.

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