Question

Jacie is a 22-year-old female with poorly controlled AD, a problem she has experienced since infancy. She has a flare on her hands that is so itchy, it's keeping her awake all night. She is moisturizing multiple times daily and using fluticasone propionate ointment 0.005% twice daily. What would be the BEST change to her regimen?

A) Switch fluticasone propionate ointment 0.005% to desonide gel 0.05%
B) Switch fluticasone propionate ointment 0.005% to hydrocortisone valerate ointment 0.2%
C) Have her apply the fluticasone propionate ointment 0.005% twice daily followed by a tepid bath
D) Switch fluticasone propionate ointment 0.005% to halcinonide ointment 0.1%

Answer 1

Switching Jacie from fluticasone propionate ointment to a more potent corticosteroid like halcinonide ointment 0.1% could potentially offer better control of her AD symptoms. Consulting with her healthcare provider is crucial before making changes to her regimen. Other treatments may be considered if topical steroids are not effective.

Step-by-step explanation:

The best change to Jacie's current regimen for poorly controlled Atopic Dermatitis (AD) would likely involve addressing both the inflammation and the intense itching that is disturbing her sleep. Given that Jacie is already diligently moisturizing and using fluticasone propionate ointment without adequate relief, a possible next step could be to switch to a more potent corticosteroid, such as halcinonide ointment 0.1%, as stronger corticosteroids can potentially offer better control of severe AD symptoms. It's important to note that corticosteroids help manage symptoms by reducing inflammation and soothing itching, but they do not treat the underlying cause of AD.

Moreover, Jacie should consult with her healthcare provider before making any changes to her treatment plan to ensure safety and proper management of her condition. Alternative treatment options may also be considered, such as systemic medications, phototherapy, or newer biologic drugs, if topical treatments are insufficient.