The rationale for the use of vitamin D derivatives in the treatment of psoriasis is based on the observation that patients with hypocalcemia often develop various forms of psoriasis, most notably the pustular form. In one case, a patient who had undergone thyroidectomy developed repeated flares of pustular psoriasis after decreases were made in her dosage of ergocalciferol (Vitamin D 2 ); each episode was related to severe hypocalcemia and resolved after her serum calcium levels normalized. 14 Another patient with osteoporosis experienced dramatic improvement in severe psoriasis after receiving an oral form of vitamin D. 15 This finding, along with the discovery that the bioactive form of 1,25-dihydroxycholecalciferol has been shown to inhibit keratinocyte proliferation and promote keratinocyte differentiation, 16 has led to the development of vitamin D analogs for the treatment of psoriasis.
Some of the generic drops have become expensive because of consolidation. For example, generic pred forte drops used to be very inexpensive but now there are only two companies that make it and those two companies are owned by the same two large pharmaceuticals that own the branded medicines, hence the price of the generic is almost the same as the expensive branded options. The price of drugs does vary from one pharmacy to another and each insurance plan has its preferred drugs which cost much less for patients depending on the deals they have made with the manufactures. For example brand A might be priced well at one store because they have made a good deal with the manufacturer and made it their preferred drug while brand B would be expensive. Across town a different drug store chain might have a great price for B and a high price for A because they have make B their preferred drug and have a great volume price with the manufacturer.
Alas, it is hard to find a cost effective way to protect your eyes around cataract surgery.
Transdermal patches (adhesive patches placed on the skin) may also be used to deliver a steady dose through the skin and into the bloodstream. Testosterone-containing creams and gels that are applied daily to the skin are also available, but absorption is inefficient (roughly 10%, varying between individuals) and these treatments tend to be more expensive. Individuals who are especially physically active and/or bathe often may not be good candidates, since the medication can be washed off and may take up to six hours to be fully absorbed. There is also the risk that an intimate partner or child may come in contact with the application site and inadvertently dose himself or herself; children and women are highly sensitive to testosterone and can suffer unintended masculinization and health effects, even from small doses. Injection is the most common method used by individuals administering AAS for non-medical purposes.