estar™

Therapeutic Tar Gel

Composition: Westwood" Tar (biologically equivalent to
5% Coal Tar USP) in hydro-alcoholic gel (29% alcohol)
Actions and Uses: A therapeutic aid in the treatment of
psoriasis and other tar responsive dermatoses such as
eczema (atopic dermatitis, lichen simplex chronicus,
númmular eczema) and seborrheic dermatitis, estar is
suitable for use in a modified Goeckerman regimen, either
in the hospital or on an outpatient basis; it also can be
used in follow-up treatment to help maintain remissions.
Contraindications: estar should not be applied to acutely
inflamed skin or used by individuals who are known to be
sensitive to coal tar.
Dosage and Administration:
Psoriasis:
The patient should massage estar into affected areas,
once or twice per day or as directed by physician. Rub in
well, allow the gel to remain for five minutes, and then
remove excess by patting with tissues.
Chronic atopic dermatitis, Lichen simplex chroni¬
cus, Nummular eczema, and Seborrheic dermatitis:
One or two applications per day, as described above, are
suggested. If dryness occurs, an emollient may be applied
one hour after estar.
Caution: AFTER USING, PROTECT TREATED AREAS FROM
SUNLIGHT UNLESS DIRECTED BY PHYSICIAN. DO NOT
USE ON HIGHLY INFLAMED OR BROKEN SKIN. If used
on the scalp, temporary discoloration of blond, bleached,
or tinted hair may occur. If undue irritation develops or
increases, discontinue use and consult physician. AVOID
CONTACT WITH EYES. In case of contact, flush eyes with
water.
Slight staining of clothing may occur. Standard laundry
procedures will usually remove stains.
For complete prescribing information, see PDR
SUPPLIED: 3 oz. plastic tube.
Balnetar®
Water-dispersible Emollient Tar
CONTAINS: WESTWOOD" TAR (Equivalent to 2.5% crude
coal tar U.S.P.) mineral oil, and lanolin oil.
Balnetar is an important adjunct in the management of a
wide range of dermatoses, including:
Atopic dermatitis
Psoriasis
Chronic eczematoid dermatitis
Eczematoid dermatitis
Seborrheic dermatitis
Suggested for use in modified Goeckerman regimen
Directions:
Balnetar should always be used with water —either added
to water or rubbed into wet skin.
Bath: Add 1 to 3 capfuls to a tub of warm water. Do not
use soap. Soak for 10 to 20 minutes. Pat dry. Frequency
depends on nature and severity of condition.
Direct Application: Pat off excess with tissue or old towel
to help minimize staining of clothing or linens.
Scalp Application: Mix 2 to 3 capfuls with % cup of water.
Rub into scalp with fingertips. Apply once a day, prefer¬
ably before bedtime. A therapeutic shampoo may be used
the following morning.
Contraindication: Not indicated when acute inflammation
is present.
CAUTION: If irritation persists, discontinue use and con¬
sult physician. In rare instances, temporary discoloration
of blond, bleached, or tinted hair may occur. In rare cases,
Balnetar may cause allergic irritations attributable to coal
tar. Keep out of the reach of children. AVOID CONTACT
WITH EYES.
PRECAUTION: After use of Balnetar, avoid exposure to
sunlight unless otherwise directed by physician GUARD
AGAINST SLIPPING IN BATHTUB. TO AVOID STAINING,
DO NOT USE IN FIBER GLASS BATHTUBS.
SUPPLIED: 8 fl. oz. plastic bottles.
Sebutone®
Therapeutic Tar Shampoo
CONTAINS: WESTWOOD" TAR (equivalent to 0.5% Coal
Tar USP) sulfur 2% and salicylic acid 2% in SEBULYTIC*
brand of unique penetrating surface-active combination
of soapless cleaners and wetting agents.
CAUTION: If undue skin irritation develops or increases,
discontinue use and consult physician. In rare instances,
temporary discoloration of blond, bleached, or tinted hair
may occur. For external use only. Keep out of the reach of
children. AVOID CONTACT WITH EYES. IN CASE OF
CONTACT, FLUSH EYES WITH WATER.
SUPPLIED: 4 and 8 oz. bottles and Sebutone Cream in
4 oz. tubes.
UJeSTLUOOD
PHARMACEUTICALS INC
Buffalo. New York 14213
In Canada. Belleville. Ontario K8N 1 E2
Spread of Condyloma Acuminata
to Infants and Children
To the Editor.Intheir letter to the
editor (Archives 112:1329,1976), Gold-
man et al indicate that condyloma
acuminata and digital or plantar
warts may spread from family mem-
ber to family member. We have had
two occasions in the past year to
suspect that young children with peri-
anal condyloma acuminata had been
sexually molested by family members
who also had condyloma acuminata.
Such an investigation might be worth-
while in the cases of Goldman and his
associates.
Additionally, the work of Cook et al
indicates that the mothers of children
with laryngeal papillomas not uncom-
monly had condyloma acuminata at
the time of delivery of their infected
children.1 Boyle and co-workers2 were
able to identify a papovavirus by elec-
tron microscopical examination of a
laryngeal papilloma obtained from an
adult and a papilloma obtained from a
child. Boyle et al further commented
on the transmissibility of the virus in
condyloma acuminata and noted that
the child in their study was born to a
mother who had genital warts.
Laryngeal papillomas in children
can be totally incapaciting and are
associated with respiratory distress
and frequent recurrences even after
the lesions have been surgically
removed. The treatment is surgical at
the present time, although the immu-
notherapeutic approach to treatment
with autogenous vaccine, as was first
suggested by Powell et al3 for condy¬
loma acuminata, has been extended by
Curtis and Ablin.4 Condyloma acumi¬
nata in pregnant women should be
treated with enthusiasm; possibly,
some obstetricians and gynecologists
may consider doing cesarean sections
in the instances of women who have
very extensive lesions. Perez-Figare-
do and Baden3 have recently men¬
tioned that podophyllum probably
should not be used in treating condy¬
loma acuminata on pregnant women
because of its known teratogenic
effect. These authors, however, do
indicate that there is no real evidence
linking the topical application of podo-
phyllum to fetal malformations, at the
present time.
A prospective study designed to
determine the incidence of laryngeal
papillomas that occur in children born
to mothers who have condyloma
acuminata at the time of delivery,
coupled with the information about
the passage of the papovavirus across
the placenta might help mold an
approach to treating condyloma acu¬
minata in pregnancy that could pre¬
vent the problem of childhood laryn¬
geal papillomas.
Frances J. Storrs, MD
Portland, Ore
1. Cook TA, Brunschwig JP, Butel JS, et al:
Laryngeal papilloma: Etiologic and therapeutic
considerations. Ann Otol Rhinol Laryngol 82:649\x=req-\
655, 1973.
2. Boyle WF, Riggs JL, Oshiro LS, et al: Elec-
tron microscopic identification of papova virus in
laryngeal papilloma. Laryngoscope 83:1102-1108,
1973.
3. Powell LC Jr, Pollard M, Jinkins JL: Treat-
ment of condyloma acuminata by autogenous
vaccine. South Med J 63:202-205, 1970.
4. Curtis WW, Ablin RJ: Immunotherapy of
condyloma acuminata. JAMA 225:994, 1973.
5. Perez-Figaredo RA, Baden HP: The phar-
macology of podophyllum. Prog Derm 10:1-4,
1976.
In Reply.\p=m-\DrStorrs has made some
very important additional points
about condylomata acuminata in chil-
dren. In our discussions with the
families of the patients, reported
previously and recently, there was no
evidence of sexual molestation by
adults as far as we could determine.
We have worked with the Depart-
ment of Otolaryngology of the Medi-
cal Center of the University of Cincin-
nati for more than 15 years on the
familial incidence of laryngeal papil-
lomas in children and on the use of
autogenous wart extracts for therapy.
These extracts are prepared from
both small bits of excised laryngeal
papillomas and from digital warts of
adults and children in the family. We
have found digital and plantar warts
in the family and the child that were
associated with the laryngeal lesions,
but we found no such associations
with genital warts, like those that
Powell et al had reported. As with any
therapy for warts without controls,

Downloaded From: http://archderm.jamanetwork.com/ by a DALHOUSIE UNIVERSITY-DAL-11762 User on 06/21/2015