Steroid withdrawal wiki

Weaker topical steroids are utilized for thin- skinned and sensitive areas, especially areas under occlusion, such as the armpit, groin, buttock crease, breast folds. Weaker steroids are used on the face, eyelids, diaper area, perianal skin, and intertrigo of the groin or body folds. Moderate steroids are used for atopic dermatitis , nummular eczema , xerotic eczema , lichen sclerosis et atrophicus of the vulva , scabies (after scabiecide) and severe dermatitis . Strong steroids are used for psoriasis , lichen planus , discoid lupus , chapped feet, lichen simplex chronicus , severe poison ivy exposure, alopecia areata , nummular eczema, and severe atopic dermatitis in adults. [1]

The obvious priority is immediate discontinuation of any further topical corticosteroid use. Protection and support of the impaired skin barrier is another priority. Eliminating harsh skin regimens or products will be necessary to minimize potential for further purpura or trauma, skin sensitivity, and potential infection. Steroid Atrophy [10] [11] is often permanent, though if caught soon enough and the topical corticosteroid discontinued in time, the degree of damage may be arrested or slightly improve. However, while the accompanying Telangectasias may improve marginally, the Striae is permanent and irreversible. [1]

Title Steroid Addiction Authors Kligman & Frosch Link http:///doi//-/epdf Quotes Steroid addiction is a more subtle and more insidious type of side reaction. It is common but is not high in medical consciousness because it frequently goes unrecognized Because it develops in stages, often slowly, both the physician and the patient may fail to incriminate the steroid Many patients were afraid to stop the drug because of the distressing rebound inflammation which followed their withdrawal. He minced no words in stating that both the skin and the patient can become "hooked" on topical steroids. Promptly, within a day or two, the (un)treated areas become reddened, tender, itchy, cracked, scaling, and may erupt into pustules, especially on the face. The original disease may exacerbate, but the key event is the re-bound dermatitis which is exceedingly un-comfortable and distressing. Stopping the steroid leads to a ferocious rebound in one or two days with fissuring, exudation, pustulation (of the face) and always with intolerable discomfort. It was unequivocally evident that the longer the steroid had been used and the greater the degree of atrophy and telangiectasia, the more intense the rebound. These patients take to the shadows, became social recluses, and sink into depressive states, occasionally with thoughts of suicidal solutions. Thus with highly potent steroids the stage for addiction can be set up within a very short period. After withdrawal, an unbelievably itchy, feral dermatitis erupts which can only be described as maddening. Dermatologists have long been familiar with the rebound exacerbation that occurs when systemic steroids are withheld from psoriatics. Few seem to sense that the same thing may happen after stopping potent topical steroids. Addiction to topical steroids is a serious medical problem which reaches tragic proportions in some cases. It Is commoner than realized, sly and seductive, and will be prevented only when physicians become as impressed with the capacity of the steroids to do harm as they are with their remarkable power to suppress but not cure virtually any inflammatory disorder. We have been able to show in human skin that triamcinolone acetonide, whose anti-inflammatory powers are in the medium range, induces atrophy which is on a par with the most powerful steroids. Withdrawal is agonizing and the doctor must be enrolled in the battle emotionally, providing strenuous support and unremitting encouragement.

Steroid withdrawal wiki

steroid withdrawal wiki

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