Dermatitis

Question 1

What are Topical Corticosteroids used for?

Answer 1

hyperproliferation, inflammation and immunologic involvement

Provide symptom relief of itching and burning

Question 2

What is the mech of action of Topical Corticosteroids?

Answer 2

• Anti-inflammatory
• Vascoconstrictive
• Immunosuppression
• Antiproliferative

Question 3

____ potency used on thin skin areas such as face and folds or mild skin conditions or in children

Answer 3

LOW

Question 4

_______ potency used medium thickness skin such as body and scalp

Answer 4

MEDIUM

Question 5

_____ potency use on thick skinned areas such as palms and soles

Answer 5

HIGH

Question 6

Response to topical corticosteroids depends on…

Answer 6

condition being treated and not just the thickness of the skin in the affected area

Question 7

Effect of vehicle on potency:

Answer 7

optimized vehicle > ointment or gels > creams or lotions

Question 8

Ointments =

Answer 8

occlusive and provide lubrication, good for dry, scaly lesions. Are greasy which tend to decrease patient compliance

Question 9

Creams =

Answer 9

generally less potent then ointments, but still have good lubrication. Often contain preservatives. Are cosmetically appealing

Question 10

Lotions or gels =

Answer 10

helpful in hairy areas

Question 11

What are the adverse effects of Topical Corticosteroids?

Answer 11

• Thin skin areas have better response but are at increased risk of AE’s
• Dryness, itching, burning & local irritation may occur
• Atrophic changes
• Infections
• Ocular changes
• Suppression of the HPA axis
• Pharmacologic effects
• Miscellaneous

Question 12

Frequency of application:

Answer 12

– Apply once or twice daily (for most preparations)
– More frequent application does not provide better results
* Applying 3 to 4 times daily is equally as effective as 1 to 2 times daily
– Less frequent application reduces risk of side effects
– Once under control, reduce frequency of application
– Tapering (decrease potency +/- decreased frequency) may be helpful to prevent rebound flares where potent or prolonged treatment is needed

Question 13

What are the non-rx tx’s and the package info:

Answer 13

Corticosteroids:
– Hydrocortisone 0.5% and Hydrocortisone 1.0%
* Package information:
– Not recommend in children <2 years old
– Max 7 day therapy

– Clobetasone butyrate 0.05% (NAPRA Schedule II)
* Package information:
– Not recommended in children <12 years old
– 7 day therapy