STL Index for: corticosteroids

The elderly population is increasing and drug dosing requires special considerations for efficacy and decreasing toxicity. This overview provides algorithms for adjusting drug and dosage based on current evidence-based knowledge with emphasis on drugs prescribed in dermatological practice.

The prevalence of eczema is increasing over the past 30 years, and is estimated to affect 20% of children in North America and Northern Europe. This article discusses eczema, incidence, clinical presentations, and management, as well as specific primary and second line therapies.

Itch is a very common feature in a variety of skin conditions. Idiopathic or non-specific itch is also common, and presents a challenge for dermatologists to manage. Diagnosis, treatment, and management strategies for various itch are discussed in this article.

Skin conditions are commonly found on the lips. Surrounding skin and mucosal surfaces may be involved, and hair problems may be present. Lesions can be single or multiple. Conditions can be localized or diffuse, with other features found upon physical examination that help to make a diagnosis.

Although the developing fetus was once considered protected from the outside world, we now know that it can potentially be affected by any medication given to the mother. Therapeutic options available for these patients will be discussed.

Psoriasis, its diagnostic features, and impact on the patient's quality of life are discussed as well as the most common topical treatments for psoriasis.

Eumovate (Clobetasone Butyrate) and their uses in treating a variety of skin conditions are discussed - clinical experience and indications. Conditions include atopic dermatitis, lichen planus, psoriasis, and seborrheic dermatitis.

Psoriasis remains a therapeutic challenge. Involvement of the scalp can be minimal (“dandruff”) or more significant and difficult to manage. Gentle treatment, reducing trauma, and treating the inflammation and pruritus will improve therapeutic results.

Topical agents for the treatment of psoriasis are indicated for patients whose affected area is < 10% of their skin. However, for long-term use, their effectiveness can be limited. Topical sequential therapy involves the application of a class I corticosteroid and calcipotriene in three different phases.

Atopic dermatitis is a highly pruritic inflammatory disorder of the skin characterized by onset in infancy or childhood and a chronically relapsing course. Mainstay treatments are emollients and topical corticosteroids, but the latter are limited by side-effects from longterm use.

Psoriasis has a greater mental and physical impact than myocardial infarction, hypertension, diabetes mellitus, arthritis, and cancer; only depression had a greater mental impact, and congestive heart failure a greater physical impact.

Eczema diagnosis, treatments, and management techniques are discussed. Diagnostic features, treatments both topical and oral, infection control, and a note on calcineurin inhibitors.

Prednicarbate is a nonhalogenated corticosteroid that is used in the treatment of inflammatory skin diseases, for example atopic dermatitis. It has a favorable benefit-risk ratio, with an inflammatory action similar to that of a medium potency corticosteroid, but with a low potential to cause skin atrophy.

Tacrolimus ointment (Protopic®, Fujisawa) is an effective agent in a class of topical immunomodulators. It has been shown to be safe and effective in adults and children with Atopic Dermatitis in short- and long-term treatments.

The exact mechanism of action of leukotriene receptor antagonists in Atopic Dermatitis is not known. In small clinical and case studies, montelukast was found to be a safe and effective alternative or steroid-sparing therapy in the management of patients with atopic dermatitis.

Hand eczema is a common skin disease that tends to become chronic and may interfere with many types of work. Emollients have been shown to be useful in reducing eczema activity and in the primary prevention of hand eczema.

Allergic contact dermatitis (ACD) may account for at least 20% of all childhood dermatitis. Clinically, its morphology is identical to other forms of dermatitis in acute, subacute and chronic forms. A persistent or unusual and localized pattern is often the key to diagnosis.

A new compound product containing calcipotriol 50μg/gm and betamethasone dipropionate 0.5mg/gm (Dovobet*, LEO Pharma) in an ointment base was recently introduced in Canada for the treatment of psoriasis.

Psoriasis is a common dermatosis, affecting children in North America. Many papers have stressed the treatments available for adult psoriasis, but few have dealt with this disorder in children. Topical treatment modalities continue to be the first line therapy for childhood psoriasis.

Pimecrolimus is an immunomodulating medication that inhibits production of inflammatory cytokines in the skin and this compound was specifically developed for the treatment of inflammatory skin diseases.

Use of medications by breast-feeding mothers is not uncommon. Information regarding the safety of common dermatological medications during lactation will be reviewed. Based on this information, treatment recommendations will be made.

Bullous pemphigoid (BP) is the most frequently occurring autoimmune blistering disease in Europe and North America. Although it is primarily a disease of the elderly, children and young adults can also develop it.

Chronic palmoplantar pustular psoriasis is a disabling condition characterized by recurrent crops of sterile pustules on a background of erythema, fissuring and scaling. Genetic and environmental factors have been implicated in its etiology.

Their management of hemangiomas has been controversial as they are unpredictable. Today there is an increased awareness of both the physical and psychological sequelae associated with hemangiomas, a small percentage of which can be life threatening. This has resulted in a renewed push to treat them.

Toxicodendron dermatitis results from a reaction to an oil soluble oleoresin that is present in many parts of the poison ivy and poison oak plants. Prophylactic measures and treatments are discussed.

With growing public reluctance to use systemic medications we can expect topical treatments for psoriasis and other skin conditions to become increasingly important in the future. These drugs are useful not only to control this disease, but also to limit the irritation caused by medications such as tazarotene and anthralin.

Currently, tacrolimus is emerging as a promising therapeutic alternative for the treatment of a number of dermatological diseases that have in common an aberrant immunologic response. This topical ointment is the first of its kind to be approved by the US FDA (December 2000), 0.1% for the treatment of moderate-to-severe atopic dermatitis in adults, and 0.03% for children older than 2 years of age and for adults who are undergoing long-term intermittent therapy.

Systemic sclerosis is a multisystem disorder with vascular instability as a clinical hallmark. Treatment currently consists of recognition and management of end-organ damage.

Behçet’s disease is an inflammatory disorder of unknown cause. There is often involvement of the gastrointestinal system, the central nervous system and large vessels, which can be life-threatening. As well, ocular lesions can cause blindness. Mucocutaneous symptoms are self-limiting but more frequent.

Vitiligo is an acquired skin disorder caused by the disappearance of pigment cells from the epidermis, and results in well defined white patches that are often symmetrically distributed. The lack of melanin pigment makes the lesional skin more sensitive to sunburn.

Localized scleroderma, or morphea, is a chronic disease that causes a thickening and induration of the skin. For plaque type morphea, the treatments include super-potent corticosteroids and calcipotriol. For the more generalized forms, as well as the linear forms, UVA is currently the best therapeutic modality.

Corticosteroids have dominated the class of anti-inflammatory agents for the past 50 years. In the last ten years, new corticosteroids have been developed for topical use. Characteristics common to these several chemically different corticosteroids are their class III, or high potency designation and their improved safety profile.

This review concentrates on those drugs which have been clearly shown, or are widely reputed, to make psoriasis worse. There is insufficient clinical evidence to justify the inclusion of many drugs which have been included in published lists of drugs said to exacerbate psoriasis.

Estimates of the percentage of patients with cutaneous lichen planus (LP) who also have oral LP vary from somewhere between a third and a half 1-3, to as high as 70% and even higher when the cutaneous lesions are of long duration.

A review of the history surrounding the Skin-Cap controversy as it unfolded.

Various treatment modalities for the treatment of scalp psoriasis are considered, as well as their upsides and downsides. A list of practical tips in management are also provided.