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Pregnancy and Skin Disease
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Tugba Kevser Uzuncakmak, Ozge Askin, Yalçın Tüzün
Management: Treatment of AEP is based on the control of pruritus and xerosis. Emollients and topical corticosteroids are first-line therapies. When topical treatment is not sufficient, narrowband UVB therapy can be effective and safe during pregnancy. Systemic corticosteroids can be considered for severe disease.
Psoriasis
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Topical treatment is indicated when it is not associated with severe skin psoriasis or psoriatic arthritis, when systemic treatment is not recommended, or in combination with systemic treatment.CorticosteroidsVitamin D analogsCalcipotriol + betamethasoneTazaroteneTacrolimusFluorouracil 1% solution in propylene glycol and urea (not in use anymore)Cyclosporine oily solution (not in use anymore)Anthralin (not in use anymore)
The Diagnosis and Management of Recurrent Aphthous Stomatitis: A Consensus Approach
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
Topical corticosteroids available in the United Kingdom to use as a mouthwash (when dissolved in water) include betamethasone tablets, soluble prednisolone, and fluticasone capsules, which are relatively easy to use and cover large areas of the mucosa. For more localised treatment corticosteroids designed for nasal use (e.g., fluticasone aqueous spray) or asthma can be applied to a single ulcer. Alternatively, topical treatment can be in the form of steroid-based creams or ointments, of which a range of potencies is available, although the use of these may be limited by the dexterity required for application and acceptability to patients. A useful summary of the topical corticosteroids commonly used in oral medicine was written by Rudralingam et al.13 Nearly all topical corticosteroids used in the mouth are used off-license, and therefore it is important that the prescriber understands the rationale and risks of their use.
Treatment satisfaction of patients with psoriasis with topical therapy in a real-world setting: unmet need for higher effectiveness
Published in Journal of Dermatological Treatment, 2023
Nadia Ninosu, Suna Hoelker, Max Kappenstein, Sylvia Buettner, Wiebke K. Peitsch, Marthe-Lisa Schaarschmidt
We show that patients with psoriasis are particularly satisfied with the safety, but rather dissatisfied with the effectiveness of topical therapy. Satisfaction with specific medications differed significantly in several domains, and fixed combinations of TCS and VDA were rated best in the domain effectiveness. Moreover, we identified several patient and disease characteristics that influence satisfaction. Our results demonstrate the importance of individualized topical treatment regimens as well as the need for novel effective topical agents. Satisfaction with topical treatments should be evaluated regularly, and reasons for dissatisfaction should be exactly elucidated. Adaptation of topical therapy to individual needs with special attention to effectiveness may increase satisfaction, which probably leads to improved adherence and, thereby, to higher treatment efficacy.
Transport of hydrocortisone in targeted layers of the skin by multi-lamellar liposomes
Published in Journal of Liposome Research, 2023
Antoine Bernasqué, Muriel Cario, Stéphanie Krisa, Sophie Lecomte, Chrystel Faure
Targeting a specific layer of the skin can be considered the grail for the pharmaceutical and cosmetic industry. Targeting the stratum corneum (SC) would allow e.g. restructuring it in pathologies where skin hydration is affected (Menon et al.2012, Pischon et al.2017), to protect it from oxidative damage (Thiele, 2001), or to prevent the entry of certain pathogens into the body (Lipsky et al.2020). Many diseases such as atopic dermatitis or melanoma originate from dysfunctions within the epidermis. Topical treatment of these diseases can cause side effects due to the passage of the active ingredient into the bloodstream. Targeting the epidermis could avoid this (Hemrajani et al.2022, Krishnan and Mitragotri 2020). Epidermis-restricted delivery of an active molecule represents a promising strategy for blood transfer diminution, drug efficiency improvement and/or drug concentration diminution into commercial products. Conversely, reaching the systemic circulation topically has advantages over oral administration by minimising metabolism, and avoiding the unfavourable gastrointestinal environment, which are responsible for the low bioavailability of many drugs, and by promoting a prolonged drug administration (Payne et al.1998).
Patterns of dosage regimen instructions regarding topical medicines: how is the information perceived by patients?
Published in Journal of Dermatological Treatment, 2022
Ana Teixeira, Maribel Teixeira, Carmen Bento, Luís Filipe Azevedo, Viviana Vasconcelos, Maria Fernanda Bahia, Tiago Torres, Carla Morna, Eunice Castro, Diogo Guedes Vidal, Hélder Fernando Pedrosa e Sousa, Maria Alzira Pimenta Dinis, Isabel F. Almeida, Vera Almeida
The definition of the amount of medicine to be applied in the case of topical treatment is a peculiarity of the dosage regimen pattern and is very important for the treatment adherence and clinical efficacy. In this study, it was found that the way in which this information is transmitted by the physicians to patients is difficult and the instructions reported by physicians differ from those perceived by the patients. There are two possible explanations for these results. Either patients do not perceive what they are told because they do not comprehend or believe in its faithfulness or, physicians are often overwhelmed with overwork and this prevents them from providing complete dosage regimen instructions. Accordingly, this study supports the importance of the delivery of appropriate and tailored instructions, confirming patients’ instructions understanding during consultations to enhance the adherence to the topical treatment. Thus, it is of crucial importance the implementation of strategies to improve the optimal communication of dosage regimen instructions by physicians. Educational workshops, written action plans, early and frequent follow-up visits and reminder systems may help overcome these barriers and improve the treatment adherence. Better adherence to treatment can lead to better clinical outcomes, quality of life and ease the economic burden.