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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Coal tar is one of the by-products when coal is carbonized to make coke or gasified to make coal gas. It is a brown or black liquid of extremely high viscosity. Coal tars are complex and variable mixtures of phenols, polycyclic aromatic hydrocarbons, and heterocyclic compounds. Coal tar products are used to relief itch, irritation, redness, dryness, scaling, and flaking of the skin caused by certain skin diseases. Coal tar ointment is a keratolytic. It works by slowing bacterial growth and loosening and softening scales and crust. Indeed, topical coal tar products are widely used in the treatment of psoriasis and atopic dermatitis, although the level of evidence of their efficacy is not strong (3) and people dislike their odor, messy application, and staining of clothing. The short-term side effects of coal tar pharmaceutical preparations are folliculitis, irritation, phototoxicity and contact allergy. Occupational dermal exposure to coal tar and coal tar pitches can be the cause of phototoxic reactions, irritation and burn, allergic dermatitis, folliculitis, occupational acne, atrophy of the epidermis, hyperpigmentation, and malignancies (22).
Topical Therapies for Psoriasis
Published in Siba P. Raychaudhuri, Smriti K. Raychaudhuri, Debasis Bagchi, Psoriasis and Psoriatic Arthritis, 2017
Various tar preparations are well established in medicine: wood tars have been used since ancient times and coal tar for about a hundred years [34,35]. Based on their anti-inflammatory, antipruritic, and antiproliferative activity, as well as antibacterial and antifungal activity, the major indications are chronic inflammatory skin diseases. Apart from psoriasis, these mainly are seborrheic dermatitis and atopic eczema [36]. Coal tar may be used as crude tar or more commonly as liquor carbonis detergens (LCD) [37]. This is a dark black, sticky liquid that is used in shampoos and ointments in concentrations up to 20%. It contains around 10,000 chemical compounds, only half of which have been identified so far and comprise polycyclic aromatic hydrocarbons (PAHs), phenols, and heterocyclic compounds [38]. It can be prepared from brown coal (lignite tar), bitumen (bituminous tar), and anthracite as the most metamorphosed type of coal (anthracite tar). Coal tar is mentioned among the most effective and safe medicines in the World Health Organization’s List of Essential Medicines. Coal tar products are mainly sold over the counter [39,40], but they may also be used as compounded preparations (0.5%–20%) in ointment bases like petrolatum and other formulations [41]. Wood, mainly pine tars, has historically also been used for the above-mentioned purposes; nowadays, however, it is mainly sold over the counter in various formulations.
Goeckerman Therapy
Published in John Y. M. Koo, Ethan C. Levin, Argentina Leon, Jashin J. Wu, Alice B. Gottlieb, Moderate to Severe Psoriasis, 2014
Historically, there have been concerns about the carcinogenic effects of tar. However, clinical and epidemiological studies following patients for an extended period of time have not observed an increased risk of cutaneous or internal malignancy with the topical use of tar [10–12]. The U.S. Food and Drug Administration also reviewed multiple studies and ultimately declared that coal tar was safe and effective for the use in patients with psoriasis and other skin conditions [13]. Finally, Goeckerman therapy should not be used to treat patients with pustular psoriasis because it has been the author’s experience that tar tends to exacerbate pustulation.
Safety considerations with combination therapies for psoriasis
Published in Expert Opinion on Drug Safety, 2020
No studies of combination therapies for psoriasis in pregnant and lactating patients are available to date. When initiating combination therapy for pregnant or breast-feeding patients, the pregnancy safety of each individual agent must be considered. Only agents safe during pregnancy and safe to be used in combination as outlined above should be considered. For example, UVB phototherapy is generally thought to be safe during pregnancy and nursing [68]. The localized use of salicylic acid and coal tar is also thought to be safe during pregnancy and nursing [116], and therefore, the combination of UVB and localized application of salicylic acid or coal tar are likely safe. Overall, TNF-α inhibitors are considered safe in pregnancy and during lactation [4,5] and can theoretically be combined with other agents safe in pregnancy such as UVB phototherapy; however, such studies are lacking. While tazarotene, acitretin, and methotrexate are contraindicated in pregnancy, data on all other agents are lacking (Pregnancy Category C under the old FDA pregnancy risk letter categories). Therefore, risks and benefits should be outweighed when considering their use as monotherapy and as part of combination therapy.
Holistic development of coal tar lotion by embedding design of experiments (DoE) technique: preclinical investigations
Published in Expert Opinion on Drug Delivery, 2020
Mandeep Sharma, Gajanand Sharma, Bhupinder Singh, Vandana Dhiman, Sanjay Kumar Bhadada, O.P. Katare
The partition coefficient of coal tar/formulation was determined by employing octanol and distilled water as non-aqueous and aqueous phase, respectively. The two phases were presaturated with respect to each other by overnight shaking at room temperature. The equal volume (40 mL) of two solvents was taken in the separation flask and the weighed amount of coal tar/formulation (400 mg) was added to it. The flask was shaken intermittently at room temperature for 48 h. After 48 h, the phases were separated and centrifuged/filtered to separate the suspended particles. The obtained clear supernatant/filtrate was analyzed, if needed after suitable dilutions, using spectrofluorometer. The partition coefficient of coal tar ‘Ko/w’ and log P was calculated using formulas mentioned in Equations 2 and 3.
Mineral oil in food, cosmetic products, and in products regulated by other legislations
Published in Critical Reviews in Toxicology, 2019
Ralph Pirow, Annegret Blume, Nicole Hellwig, Matthias Herzler, Bettina Huhse, Christoph Hutzler, Karla Pfaff, Hermann-Josef Thierse, Tewes Tralau, Bärbel Vieth, Andreas Luch
From the dermatological point of view, the pharmacological effect of mineral oil-based products such as petrolatum (see Chapter “Mineral oils in medicinal products”) is of primary importance for the health assessment of mineral oils in cosmetic products. In the US, petrolatum is approved for infection prophylaxis after dermatosurgery and for the maintenance therapy of atopic dermatitis (AD). There is mounting evidence that PAHs play a critical role in mediating the beneficial effect (see below). PAHs occur not only in mineral oil-based products, they are highly enriched in coal tar also. Coal tar-based products are also used to treat AD and other chronic skin diseases such as psoriasis. The following summary of selected studies on petrolatum and coal tar considers the dermatological viewpoint.