Eczema is an
inflammatory condition of the skin, the cause of which may be from outside environment, immune system, or a
combination of both.
The patients and the treating doctor hope the effective
and convenient dermatological therapy. Physical therapy is usually inconvenient
and need to a lot of patient but is effective. Systemic therapy is considered
to be effective immediately. The patient and the treating doctor are often
being conservative due to the risk of potential side effect. The following is
dermatological therapies.
Topical
Corticosteroids
Topical
corticosteroids are certainly the mainstay of dermatological treatment of inflammatory
conditions. Corticosteroids
function via by inducing
suppression of inflammatory cytokines and inhibiting function of T cells and a range of other inflammatory cells. The production
of arachidonic acid which is one
of the fatty acid in skin is affected as well as the function of vascular and connective tissues. The potency
of a steroid is based on its side effect. The ranges are from class 1 to class7.
Side effects, especially after long-term use, include atrophy of the skin, occurrence of telangiectasia, and,
particularly in the elderly, skin purpura. Secondary infection can be a
problem, particularly folliculitis and a special form of dermatitis called perioral
dermatitis. Use of appropriate strengths for different localizations on the body eases some of the side effect problems. For instance, the face should only be treated with
weak steroids, and intertriginous areas (groin and axilla) should only be treated with
weak or moderate-strength steroids. This
is because the absorption is more medication than other areas.
(Ref. national eczema
org.)
Some of common side effects:
·
thinning
of the skin (atrophy)
·
Skin
thickening (lichenification)
·
Stretch
marks (striae)
·
Darkening
of the skin
on the face and around the mouth,
can cause other types of side effects (some of them more severe)
Some other possible side effects
Glaucoma
Cataracts
Tiny pink bumps on the skin
Acne
Red, pus-filled hair follicles
(called folliculitis, which is rare)
Adrenal suppression
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