Betamethasone butyrate propionate/indometacin farnesil
Lack of efficacy: case reportA 70-year-old man exhibited lack of efficacy during treatment with betamethasone butyrate propionate and indometacin farnesil for eosinophilic pustular folliculitis [not all routes and dosages stated].The man presented with a 7 month history of disseminated pruritic red-to-brown papules on his trunk, face and extremities. He also had scaly erythema on the soles. He had been treated with minocycline and betamethasone butyrate propionate ointment. However, the treatment was ineffective. After subsequent investigations, he was diagnosed with eosinophilic pustular folliculitis (EPF). He was initiated on treatment with tacrolimus applied to his face, along with oral indometacin farnesil [indomethacin farnesyl] and unspecified corticosteroids. Tacrolimus showed improvement, however, indometacin farnesil and the corticosteroids were ineffective. Eventually, his disease progressed covering 80% of body surface and mimicked papuloerythroderma of Ofuji.The man had several investigations, which ruled out internal and haematological malignancy. Subsequently, he was treated with ciclosporin and showed significant improvement in the cutaneous symptoms. Ciclosporin was gradually tapered off and his symptoms did not recur.