Corticosteroids erythema treatment

When a peel causes localized inflammation that visibly develops into hyperpigmentation, even with sun protection and avoidance, a corticosteroid (preferably a fluoro-corticosteroid) should be applied. It should be applied twice a day locally to the erythema before it develops into hyperpigmentation and should not be used long term (1 week at the most), to avoid the side-effects associated with corticosteroids. This treatment should of course be combined with sun protection/avoidance measures and a topical depigmenting agent. 

Erythema, inflammation, pain, and itching caused by contact dermatitis can be effectively treated with topically applied corticosteroids. With such a wide range of products and potencies available, an appropriate steroid selection is based on severity and location of the lesions. Table 62-6 shows a list of topical steroids and their potencies. Higher-potency preparations are used in areas where penetration is poor, such as on the elbows and knees. Lower-potency products should be reserved for areas of higher penetration, such as on the face, axillae, and groin. Low-potency steroids are also recommended for the treatment of infants and children.32,33... 

Giant cell arteritis (cranial or temporal arteritis) is an inflammatory condition that may affect any of the large arteries, especially the temporal and occipital arteries. The thickened temporal arteries may be tender and non-pulsatile, with erythema and oedema of the overlying skin. Early treatment with high-dose corticosteroids such as prednisolone is essential and should be continued for a minimum of 2-3 years at a reduced dose. 

Fluorouracil (Efudex, Fluoroplex) is an antimetabolite used for the topical treatment of actinic keratoses. It is also useful for the treatment of superficial basal cell carcinomas when conventional surgical modalities are impractical. Local inflammatory reactions characterized by erythema, edema, crusting, burning, and pain are common (and, some would argue, desirable) but may be minimized by reduced frequency of application or use in combination with a topical corticosteroid. 

A 60-year-old man underwent coronary angiography with iopamidol 200 ml. One day later he developed infiltrated erythema of the face with a generalized maculopapular rash. The skin symptoms receded within 1 week after treatment with a corticosteroid ointment. Coronary angiography with iopamidol was repeated 3 years later and again within 1 day a maculopapular rash developed and regressed within a few days with intravenous dimethindene and prednisolone-21-hydrogen succinate. 

Topical corticosteroids are the most widely used agents in the treatment of psoriasis in the United States. They are often used to decrease erythema, scaling, and pruritus. Topical vasoconstricting potencies of corticosteroids are ranked by the Stoughton-Cornell classification in seven classes (Table 96-4). Class I steroids are very high-potency products such as clobetasolpropionate 0.05%, halobetasolpropionate, and betamethasone dipropionate. ... 

Predominant treatment-related adverse effects are mild to moderate pruritus, burning, stinging, or erythema. These local reactions have been shown to be dose- and frequency-related." " Tazarotene is often used in combination with topical corticosteroids to decrease... 

Hemolytic anemia, rash, and liver damage may occur even with normal doses. In cases of overdosage, headache, vomiting, insomnia, and tachycardia are possible. Reactions may occur in leprosy with or without therapy. In lepromatous leprosy there is erythema nodosum, fever, and in some cases severe malaise. In tuberculoid leprosy the pain increases. About 50% of the treated patients with lepromatous leprosy show erythema nodosum within the 1st year, lasting for 2 weeks. As a rule, therapy with sulfones in combination with clofazimine may be continued in spite of the erythema nodosum. Analgetics, corticosteroids, and thalidomide are suitable for the treatment of leprosy reactions (Rea and Levan 1975). 

Persistent erythema, due to angiogenic factors stimulating vasodilatation, is considered a physiological event if it occurs within 3 weeks after the peel procedure [6]. If erythema associated with pruritus persists for more than 3 weeks, treatment with potent topical corticosteroids, systemic corticosteroids, and/or intralesional corticosteroids should be administered. Silicone sheets or pulsating dye laser treatments may be also adopted, especially when evident thickening or scarring has occurred [6, 15]. 

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