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Different formulations have been developed in an effort to enhance the delivery of topical corticosteroids. Betamethasone valerate in a foam had superior efficacy for scalp psoriasis and was preferred by patients when compared with betamethasone valerate lotion [ 20 ]. The foam becomes a liquid on contact with skin and is also well tolerated by patients with trunk and extremity psoriasis [ 21 ]. A clobetasol propionate spray is also available; like foams, sprays are easy to apply to large areas [ 22 ]. The main advantage of these newer preparations is likely greater patient acceptance, which may translate into greater adherence; the main disadvantage is cost.