Short-Contact Therapy

It is now six years since my colleagues and I predicted from pharmacokinetic studies that, in topical treatment, removing drugs from the skin after a short contact period should reduce side effects.1At that time, we successfully applied this idea to the treatment of psoriasis with anthralin.1 Meanwhile, more pharmacokinetic evidence has been gained that confirms early observations with steroids2and our first investigations3,4: "Penetration into eczematous skin is much more rapid and higher than in normal skin." Thus, if we interrupt the application early enough, we hardly interfere with the therapeutic action, but we might prevent a drug-related reaction—ie, side effects—in perilesional skin.5-9 The idea has been utilized, sometimes with modifications, by many individual dermatologic practitioners, with almost unanimous confirmation of the concept and its practicability.10-23A restriction should be underlined immediately, that is, that the short-contact therapy needs an intelligent, motivated,