Today, many
therapies are available for the treatment of
psoriasis and
eczema. One of the oldest topical
therapies is
coal tar.
Coal tar has been used for decades, but over the past years, the use of
coal tar has decreased for several reasons, including the supposed carcinogenicity of
coal tar. We investigated the current and past treatment policies for
psoriasis and
eczema with special emphasis on the use of tar products; a postal survey was conducted among all dermatologists in two European countries: the Netherlands (n = 360) and the Flemish speaking part of Belgium (Flanders) (n = 328). This study was conducted as part of the ongoing LATER-study ("Late effects of
coal tar treatment in
eczema and
psoriasis; the Radboud study"). All practising dermatologists received a questionnaire. Dermatologists were asked to describe their treatment policies in mild/moderate
psoriasis, severe
psoriasis, mild/moderate
eczema and severe
eczema. The response rate to the questionnaire was 62.5% for the Dutch dermatologists and 45.7% for the Flemish dermatologists. Almost all dermatologists prescribe topical
corticosteroids. In
eczema, most of the dermatologists prescribe the recently introduced
calcineurin inhibitors (95%).
Coal tar is a second choice topical
therapy. Dutch dermatologists mainly use tar in the treatment of
eczema (72% vs. 48% in Flanders), whereas in Flanders, tar is mainly prescribed in
psoriasis (60% vs. 41% in Holland). Flemish dermatologists very frequently prescribe PUVA in
psoriasis (93% vs. 63%). Topical treatment, especially topical
corticosteroids, is the mainstay in
psoriasis and
eczema.
Coal tar still is an important (second choice)
therapy for the topical treatment of
psoriasis and
eczema, but its use varies from country to country. Despite the carcinogenicity of PUVA, this
photochemotherapy is frequently prescribed by dermatologists, mainly in Flanders.