Itching in Pregnancy (See Also Rashes in Pregnancy)
Tony Hollingworth in Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Management of itching in pregnancy is limited and follows a stepwise pattern (Box 1). Management of specific dermatological problems may involve specific treatments together with advice from the local dermatology department. Primarily dermatological conditions such as eczema and psoriasis (which are frequently itchy despite what the textbooks say) may require ongoing treatment with topical steroids. When advocating topical steroids, it is advisable to prescribe ointments, to keep to the lowest strength possible (no stronger than betamethasone 0.1 per cent on the body and hydrocortisone 1 per cent on the face), and to use steroids for pulses of no longer than 6 weeks. Topical steroids are the treatment for inflammation (although cessation of inflammation usually means cessation of itch) and so should be stopped as soon as the disease improves.
Use of Dermatologics during Pregnancy
“Bert” Bertis Britt Little in Drugs and Pregnancy, 2022
Dermatologic disorders are frequent among pregnant women, but few conditions are unique to pregnancy. However, pruritic urticarial papules and plaques of pregnancy, herpes gestationis (pemphigoid gestationis), prurigo of pregnancy, intrahepatic cholestatis of pregnancy, impetigo herpatiformis, pruritic folliculitis, and papular dermatitis of pregnancy are unique to pregnancy. Various dermatologic preparations are available for local and systemic use, some of which are available over the counter. Most of these agents can be used with little or no risk to the unborn child, EXCEPT FOR THE RETINOIDS. Two of the most potent known human teratogens, etretinate and isotretinoin, are dermatologic drugs. Six major categories of dermatologic preparations are reviewed in this chapter: (1) Vitamin A derivatives, (2) antibiotics, (3) antifungals, (4) antiseborrheics, (5) adrenocorticosteroids, and (6) keratolytics, astringents, and defatting agents. Dermatologic conditions unique to pregnancy and common dermatologic conditions that may occur during pregnancy are discussed under “Special Considerations.”
Radiation Sources and Interaction with Skin
Henry W. Lim, Herbert Hönigsmann, John L. M. Hawk in Photodermatology, 2007
Sunlight represents the ultimate source of life and energy on this planet, yet excessive exposure to solar energy is clearly deleterious to biologic systems. For humans the correct balance of light exposure necessary for health maintenance varies dramatically between individuals based on skin phenotype, presence of pathologic photosensitivity, and genetic factors. For otherwise normal and healthy individuals, sunlight is necessary for promoting a psychological sense of well being as well as providing the energy for endogenous vitamin D synthesis. On the other hand, excessive sunlight leads to photoaging, immunosuppression, and photocarcinogenesis. For certain dermatologic patients, sunlight can represent either the key pathogen that precipitates a dermatosis (e.g., solar urticaria) or the means by which a skin condition can be ameliorated or treated (e.g., psoriasis). Furthermore, as exemplified by polymorphous light eruption, sunlight can also, paradoxically, serve as the inciting factor and also a means for relief (i.e., natural hardening with repeated sunlight exposure).
Assessment of topical steroid phobia in dermatology patients, a cross-sectional study from an urban area of Pakistan
Published in Journal of Dermatological Treatment, 2022
Sadia Masood, Palwasha Jalil, Safia Awan, Unzela Ghulam, Sabeika Raza Kerawala
Dermatology is a unique clinical field where most of the diseases are directly visualized and the same goes for most of the treatments, which is applied directly on the target organ that is "skin". Corticosteroids are the most commonly used medicine within the domain of dermatology. They have anti-inflammatory, immunosuppressive, and anti-mitogenic properties which make them a preferred drug for many dermatological conditions1. The skin diseases treated by topical corticosteroids (TCS) ranges from a mild inflammatory patch to a more advanced form of conditions like eczemas, psoriasis, blistering disorders, or even skin emergencies such as Stevens-Johnson syndrome2. Topical corticosteroid has been well known as a magic drug, despite having its own merits and demerits. It is safe and effective when used judicially as per instructions and has very few side effects. However, inappropriate use of the same medicine can lead to disastrous effects. It is an easily available, over the counter drug, especially in the lower middle-income countries. It has raised the instance of steroid misuse leading to serious local and systemic adverse effects3. The problem raised not only due to easy availability and self-medication practices but also due to lack of proper specialist services and increasing practice of TCS by non-dermatologists.4
Skin subtype categorization based on a new questionnaire for Korean women
Published in Journal of Cosmetic and Laser Therapy, 2019
Byeong Jin Park, Jeong Eun Kim, JooYeon Ko, Myoung Shin Kim, Eun Joo Park, Ga Young Lee, Jong Hee Lee, Jung Im Na, Sung Eun Chang
A total of 512 female patients were included in the study and patient characteristics are summarized in Table 1; 141 of 512 patients (27.5%) were in the third decade, followed by fourth (27.1%), fifth (21.3%), sixth (15.4%), and seventh (2.1%) decade groups. Patient mean age was 37.4 years. The patients’ modified Fitzpatrick’s skin phototypes included 2 (0.4%) with skin phototype 2, 8 (1.6%) with skin phototype 2.5, 115 (23.6%) with skin phototype 3, 175 (35.9%) with skin phototype 3.5, 147 (30.1%) with skin phototype 4, 33 (6.8%) with skin phototype 4.5, and 8 (1.6%) with skin phototype 5. In total, 276 patients with dermatologic comorbidities were reported (53.9%). The most common dermatologic comorbidity was acne vulgaris (82 patients, 29.7%), followed by rosacea (77 patients, 27.9%), contact dermatitis (62 patients, 22.5%), seborrheic dermatitis (25 patients, 9.1%), atopic dermatitis (17 patients, 6.2%), melasma (13 patients, 4.7%), and other diseases including urticaria, vitiligo, psoriasis, post-inflammatory hyperpigmentation, and Riehl’s melanosis.
Strategies to maximize clinical efficiency while maintaining patient safety during the COVID-19 pandemic: an interview-based study from private practice dermatologists
Published in Journal of Dermatological Treatment, 2022
Kaitlyn M. Yim, Rebecca M. Yim, Sara Gaspard, Jamie MacDougall, April W. Armstrong
California, the most populous state in the U.S., has the highest number of confirmed COVID-19 cases to date (2). Within California, Los Angeles County by far comprises the highest percentage of these cases at more than 35% of the state total (6). The government of California issued a stay-at-home order in March 2020. This was loosened in May 2020, however cases in California continue to rise. Due to the dynamic nature of the COVID-19 pandemic in California and the large number of people impacted by it, dermatologists in this region have been tasked with balancing efficiency, efficacy, and safety in their practices. In this study, private practice dermatologists working in metropolitan areas mainly within the Southern California region were interviewed about how the COVID-19 pandemic has affected their practices and how they have responded. This paper will summarize various strategies dermatologists have implemented to continue to treat dermatologic conditions effectively and maintain productivity, while prioritizing the safety of providers, staff, and patients.
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