Steroid induced rosacea flare up

Oral steroids ( prednisone , [ Medrol ]) can help severe cases of hives in the short term, but their usefulness is limited by the fact that many cases of hives last too long for steroid use to be continued safely. Other treatments have been used for urticaria as well, including montelukast ( Singulair ), ultraviolet radiation , antifungal antibiotics, agents that suppress the immune system, and tricyclic antidepressants ( amitriptyline [ Elavil , Endep ], nortriptyline [ Pamelor , Aventyl], doxepin [Sinequan, Adapin]). Evidence to support the benefit of such treatments is sparse. In ordinary cases, they are rarely needed. A new treatment recently available for chronic urticaria is the monthly subcutaneous injection of a monoclonal antibody, omalizumab ( Xolair ), directed against the IgE receptor on human mast cells.

Conditions of the human integumentary system constitute a broad spectrum of diseases, also known as dermatoses , as well as many nonpathologic states (like, in certain circumstances, melanonychia and racquet nails ). [15] [16] While only a small number of skin diseases account for most visits to the physician , thousands of skin conditions have been described. [14] Classification of these conditions often presents many nosological challenges, since underlying etiologies and pathogenetics are often not known. [17] [18] Therefore, most current textbooks present a classification based on location (for example, conditions of the mucous membrane ), morphology ( chronic blistering conditions ), etiology ( skin conditions resulting from physical factors ), and so on. [19] [20] Clinically, the diagnosis of any particular skin condition is made by gathering pertinent information regarding the presenting skin lesion (s), including the location (such as arms, head, legs), symptoms ( pruritus , pain), duration (acute or chronic), arrangement (solitary, generalized, annular, linear), morphology ( macules , papules , vesicles ), and color (red, blue, brown, black, white, yellow). [21] Diagnosis of many conditions often also requires a skin biopsy which yields histologic information [22] [23] that can be correlated with the clinical presentation and any laboratory data. [24] [25] [26]

Steroid-induced rosacealike dermatitis (SIRD) is an eruption composed of papules, pustules, papulovesicles, and sometimes nodules with telangiectatic vessels on a diffuse erythematous and edematous background. It results from prolonged topical steroid use or as a rebound phenomenon after discontinuation of topical steroid. There are 3 types of SIRD that are classified based on the location of the eruption: perioral, centrofacial, and diffuse. Diagnosis of this disease entity relies on a thorough patient history and physical examination. Treatment involves discontinuation of the offending topical steroid and administration of oral and/or topical antibiotics. Topical calcineurin antagonists should be considered as alternative or adjunctive therapies for patients who do not respond to traditional treatments. Dermatologists may need to provide psychological support during office visits for patients who have difficulty dealing with the discontinuation of topical steroid and/or the psychological impact of a flare. Epidemiology, pathogenesis, histopathology, and differential diagnosis of the entity also are reviewed.

Steroid induced rosacea flare up

steroid induced rosacea flare up


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