{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T18:07:42Z","timestamp":1773770862492,"version":"3.50.1"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background\/Objectives: Topical treatment efficacy is fundamentally dependent on effective delivery of the active pharmaceutical ingredient and its compatibility with the compromised skin barrier. Many commercially available industrial formulations contain poorly tolerated excipients or lack essential therapeutic combinations, frequently leading to complex polypharmacy and reduced patient adherence. In contrast, magistral galenic preparations offer a degree of therapeutic personalization unmatched by standardized products, positioning the compounding laboratory as a strategic resource in dermatological care. This analysis aims to identify and evaluate ten indispensable magistral formulations selected based on their high clinical frequency and the absence of equivalent, globally available commercial alternatives. Materials and Methods: Each formulation was according to four strategic pillars: (i) dosage customization, (ii) excipient modification (removing allergens like parabens or fragrances), (iii) synergistic ingredient association, and (iv) vehicle optimization. The dermatological conditions addressed include pediatric scabies, melasma, hidradenitis suppurativa, and autoimmune mucosal diseases. Key selections include Kligman\u2019s formula for hyperpigmentation and personalized trichological preparations. Results: The identified \u201ctop 10\u201d magistral formulation reveals significant gaps within the standardized pharmaceutical market. In pediatric scabies (specifically patients &lt; 15 kg), benzyl benzoate and precipitated sulfur demonstrate superior efficacy over permethrin, addressing emerging resistance patterns. For acute inflammatory dermatoses, Hoffmann Paste and Lime Liniment provide effective protective barriers while neutralizing local acidity. Antiseptic and astringent solutions, including Burow\u2019s and Silver Nitrate (AgNO3) offer targeted mechanisms and biocidal activity, often absent in standardized topicals. Furthermore, specialized adhesive oral pastes for autoimmune conditions minimizing systemic absorption and associated risks. Conclusions: Magistral compounding represents a cornerstone of precision medicine in dermatology enabling tailored therapies that bridge critical gaps left by standardized formulations, particularly in complex cases and vulnerable populations.<\/jats:p>","DOI":"10.3390\/medicina62030559","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:50:48Z","timestamp":1773759048000},"page":"559","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magistral Galenic Preparations in Modern Dermatology: Our Top 10 Picks for Bridging Therapeutic Gaps"],"prefix":"10.3390","volume":"62","author":[{"given":"Edoardo","family":"Cammarata","sequence":"first","affiliation":[{"name":"Struttura Complessa a Direzione Universitaria Dermatologia e Venereologia, Azienda Ospedaliero-Universitaria Maggiore della Carit\u00e0 di Novara, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elia","family":"Esposto","sequence":"additional","affiliation":[{"name":"Struttura Complessa a Direzione Universitaria Dermatologia e Venereologia, Azienda Ospedaliero-Universitaria Maggiore della Carit\u00e0 di Novara, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Cristina","family":"Gironi","sequence":"additional","affiliation":[{"name":"Struttura Complessa a Direzione Universitaria Dermatologia e Venereologia, Azienda Ospedaliero-Universitaria Maggiore della Carit\u00e0 di Novara, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4537-3014","authenticated-orcid":false,"given":"Elisa","family":"Zavattaro","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1636-8411","authenticated-orcid":false,"given":"Paola","family":"Savoia","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","first-page":"738","article-title":"Compounding as a current therapeutic option in dermatology","volume":"104","author":"Sancho","year":"2013","journal-title":"Actas Dermosifiliogr."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Oliveira, R., and Almeida, I.F. (2023). Patient-Centric Design of Topical Dermatological Medicines. Pharmaceuticals, 16.","DOI":"10.3390\/ph16040617"},{"key":"ref_3","first-page":"1061","article-title":"Topical preparations and their use in dermatology","volume":"14","author":"Wohlrab","year":"2016","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/j.1610-0387.2007.06321.x","article-title":"Galenics of dermal products\u2014Vehicles, properties and drug release","volume":"5","author":"Daniels","year":"2007","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_5","first-page":"023","article-title":"Excipients and Vehicles in Galenic Practice: Considerations for Neonatology and Pediatrics: An Overview and Results of a Practical Experience","volume":"8","author":"Luisetto","year":"2025","journal-title":"J. Adv. Pediatr. Child Health"},{"key":"ref_6","unstructured":"Leigheb, G., and Lanfranchi, M.L. (1987). Terapia Galenica in Dermatologia [Galenic Therapy in Dermatology], Lombardo Editore."},{"key":"ref_7","first-page":"357","article-title":"Treatment of scabies using 8% and 10% topical sulfur ointment in different regimens of application","volume":"11","author":"Sharquie","year":"2012","journal-title":"J. Drugs Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1111\/ced.15076","article-title":"Topical potassium permanganate solution use in dermatology: Comparison of guidelines and clinical practice","volume":"47","author":"Chin","year":"2022","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1056\/NEJMoa1202657","article-title":"Topical paromomycin with or without gentamicin for cutaneous leishmaniasis","volume":"368","author":"Salah","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S1085-5629(97)80019-3","article-title":"Oral lichen planus: Topical and systemic therapy","volume":"16","author":"Miranda","year":"1997","journal-title":"Semin. Cutan. Med. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/j.1525-1470.2008.00725.x","article-title":"Skin care of the diaper area","volume":"25","author":"Adam","year":"2008","journal-title":"Pediatr. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1001\/archderm.1975.01630130042004","article-title":"A new formula for depigmenting human skin","volume":"111","author":"Kligman","year":"1975","journal-title":"Arch. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"439.e1","DOI":"10.1016\/j.jaad.2006.10.005","article-title":"Two randomized studies demonstrate the efficacy and safety of dapsone gel, 5% for the treatment of acne vulgaris","volume":"56","author":"Draelos","year":"2007","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1365-2230.2009.03377.x","article-title":"Resorcinol peels as a possible self-treatment of painful nodules in hidradenitis suppurativa","volume":"35","author":"Boer","year":"2010","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.1080\/09546634.2021.1945527","article-title":"Minoxidil: A comprehensive review","volume":"33","author":"Gupta","year":"2022","journal-title":"J. Dermatol. Treat."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Carvalho, M., and Almeida, I.F. (2022). The Role of Pharmaceutical Compounding in Promoting Medication Adherence. Pharmaceuticals, 15.","DOI":"10.3390\/ph15091091"},{"key":"ref_17","first-page":"753","article-title":"Modern topical drugs-new developments in galenics and pharmacology","volume":"75","author":"Eichner","year":"2024","journal-title":"Dermatologie (Heidelb.)"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.addr.2011.01.012","article-title":"Nanoparticles and microparticles for skin drug delivery","volume":"63","author":"Prow","year":"2011","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"173691","DOI":"10.1016\/j.ejphar.2020.173691","article-title":"Nanocarriers for treatment of dermatological diseases: Principle, perspective and practices","volume":"890","author":"Ramanunny","year":"2021","journal-title":"Eur. J. Pharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Almoshari, Y. (2022). Novel Hydrogels for Topical Applications: An Updated Comprehensive Review Based on Source. Gels, 8.","DOI":"10.3390\/gels8030174"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1080\/10837450.2021.2004606","article-title":"Insightful exploring of advanced nanocarriers for the topical\/transdermal treatment of skin diseases","volume":"26","author":"Nasr","year":"2021","journal-title":"Pharm. Dev. Technol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3216","DOI":"10.2174\/0929867327666200831125656","article-title":"Nanotechnology-based Drug Delivery Systems as Potential for Skin Application: A Review","volume":"28","author":"Baveloni","year":"2021","journal-title":"Curr. Med. Chem."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/559\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T14:57:31Z","timestamp":1773759451000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/3\/559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["medicina62030559"],"URL":"https:\/\/doi.org\/10.3390\/medicina62030559","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}