Therapeutic target
- Symptom relief, i.e., treatment of itching.
Therapy recommendations
- External therapy (topical therapy)
- Glucocorticoids
- Circumscribed low-symptom findings: 0.25% prednicarbate; 0.1% mometasone furoate (both are potent group substances)
- Persistent cases: 0.05% clobetasol (among the most potent topical preparations (class 4)).
- If necessary, also injecting the foci with glucocorticoid crystal suspension triamcinolone acetonide (moderately potent topical preparation (group 2)).
- Calcineurin inhibitors: tacrolism or pimerolism (off-label use, i.e., prescribing a finished drug outside the use authorized by drug regulatory authorities)
- Glucocorticoids
- Internal therapy (systemic therapy)
- Acitretin (retinoid = substance related to vitamin A) → inhibits new skin cell formation and normalizes keratinization, regulates cellular differentiation, increases sweating ability; initially 0.5 mg/kg bw/day, maintenance dose 0.1-0.2 mg/kg bw/day according to clinical picture; discontinuation trial after half a year at the earliest.
- Acitretin and glucocorticoids such as prednisolone (initially 0.5 mg/kg bw/day; note: tapering over a period of 4 to 6 weeks; maintenance dose according to clinical picture: 5 to 10 mg/d)
Phytotherapy
Subsequent plant ingredients with cooling effect are used externally and have an antipruritic effect:
- Camphor
- Mint oil
- Peppermint oil
- Menthol (1% cream)
