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Dermatitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Allison Perz, Tara Jennings, Robert Duffy, Warren Heymann
Management: AD is a chronic disorder that is prone to flares, particularly with environmental triggers. Management includes both medication and lifestyle changes. Topical corticosteroids applied twice daily as needed are the mainstay of treatment, such as topical hydrocortisone 2.5%, topical fluticasone 0.05%, or more potent steroids, such as topical clobetasol 0.05%. Tacrolimus ointment, pimecrolimus cream, or topical crisaborole can be used on the face and intertriginous areas.
Immunomodulating Agents in Gastrointestinal Disease
Published in Thomas F. Kresina, Immune Modulating Agents, 2020
Samir A. Shah, Athos Bousvaros, A. Christopher Stevens
Topical steroids, like topical 5-ASA, have been successfully used in treating active distal colitis. Truelove first reported in 1956 that two-thirds of patients with active distal ulcerative colitis treated with 120-ml enemas containing 100 mg of hydrocortisone had a favorable symptomatic response [71]. Subsequent controlled trials have confirmed the efficacy of topical hydrocortisone and topical prednisolone compared to that of placebo [72,73]. The most commonly used topical steroids are 100-mg hydrocortisone enemas and 20-mg prednisolone enemas, with response rates of about 70% [74,75].
Topical Corticosteroids
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Deepika Pandhi, Vandana Kataria
In 2008, Sassi et al. compared topical hydrocortisone 17-butyrate in combination with laser versus laser used as a monotherapy. A statistically significant difference in favor of the combination treatment was observed. Participants on combination therapy were more than twice as likely to achieve 75% repigmentation than those receiving laser treatment alone [17]. Combination treatment of hydrocortisone 17-butyrate with 308 excimer laser has also been documented to be synergistic in the same study.
Generalized lichen nitidus in a 6-year-old girl with Down syndrome
Published in Baylor University Medical Center Proceedings, 2022
Joshua A. Peterson, Travis S. Dowdle, William D. Boothe, Brett A. Austin, Cloyce L. Stetson
On physical exam, hundreds of coalescing, monomorphic papules were found on the face, trunk, extremities, and intertriginous areas (Figure 1a). Lesions varied between scaly and shiny, and some linear papules due to koebnerization were found on the right arm (Figure 1c). Based upon clinical presentation, the patient was diagnosed with lichen nitidus and atopic dermatitis. Further inquiry revealed that the pruritus was limited to areas of the body appearing to be affected by atopic dermatitis (specifically, the nape of the neck and arms), and areas with a higher concentration of lesions appearing to be lichen nitidus (specifically, the face and trunk) were minimally pruritic. Topical hydrocortisone 2.5% ointment and topical triamcinolone 0.1% ointment twice daily were prescribed as needed when her symptoms worsened.
Practical use and prescription of ocular medications in children and infants
Published in Clinical and Experimental Optometry, 2021
Ann L Webber, Phillipa Sharwood
Severe acute flares or recalcitrant chronic disease may require the use of topical steroids. Fluorometholone, e.g. FML or Flarex, provides ocular surface anti-inflammatory action with reduced intraocular penetration so it is less likely to lead to an IOP rise or cataract formation than more potent steroids such as dexamethasone or prednisolone. This is usually commenced at 2–3x day instillation and then weaned over a couple of weeks as symptoms improve. Topical hydrocortisone ointment (Hycor 1%) is useful to instil at night-time while asleep in children who are resistant to eye drop instillation or to apply for a short period to the eyelids in children with associated periocular eczema. Although hydrocortisone 1% is a mild steroid, the ointment form has prolonged contact with the eye and more intraocular penetration, thus has a higher risk of intraocular pressure rise.
Transient localized cutaneous reaction after onabotulinumtoxinA aesthetic injection
Published in Baylor University Medical Center Proceedings, 2020
Emily K. Haque, Yousef R. Darwish, Claire S. Reddick
Approximately 24 h after the procedure, a diffuse acneiform eruption appeared on the patient’s forehead (Figure 1a). The skin had a diffuse, coalescing, papular erythematous rash over the forehead without pustules or comedones without extension into the scalp or below the frontalis muscle. The patient reported no itching, warmth, or urticaria. She did not report any exercise, excess sun exposure, new moisturizer use, or other environmental triggers. She was instructed to continue her daily cetirizine and apply topical hydrocortisone 1% twice a day as needed, showing improvement in 1 to 2 days (Figure 1b). Biopsy was deferred due to the patient’s esthetic concerns and because the results were unlikely to change management. The rash completely resolved 1 week after the procedure.