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A woman developed a pruritic exacerbation of her methotrexate-dependent psoriasis after applying topical calcipotriene ointment. Patch test reactions were positive to propylene glycol 1 percent and white petrolatum, but to none of the other ingredients of the medication. Physicians would be advised to patch test patients to both the therapeutic medication and the excipients of topical substances to which patients have adverse reactions. By so doing, an allergic reaction to one or more of the excipients may be found, thus the patient may be provided the benefit of the topical medication by using it in a form that does not contain the allergenic substance.

A 2-week, double-blind clinical trial was conducted to compare the efficacy and cosmetic acceptability of amcinonide cream 0.1 percent and halcinonide cream 0.1 percent in the treatment of 29 patients with eczematous dermatitis. The dermatologic status of each patient was rated by improvement in clinical signs and symptoms, by the investigator's overall evaluation, and by two patient evaluations. Both medications produced statistically significant and equivalent improvement by Week 2. However, amcinonide was significantly favored in the efficacy evaluation of relief from burning pain at Week 2 and in patient acceptability evaluations in regard to the absence of burning, stinging, and itching on application. The role of propylene glycol in the formulation of the halcinonide cream as a contributing cause of irritation is noted.