Pruritic manifestations of corticosteroid-responsive dermatoses

Occlusive Dressing Technique

Occlusive dressings may be used for the management of psoriasis or other recalcitrant rub a small amount of cream into the lesion until it disappears. Reapply the preparation leaving a thin coating on the lesion, cover with pliable nonporous film, and seal the edges. If needed, additional moisture may be provided by covering the lesion with a dampened clean cotton cloth before the nonporous film is applied or by briefly wetting the affected area with water immediately prior to applying the medication. The frequency of changing dressings is best determined on an individual basis. It may be convenient to apply Triamcinolone acetonide cream under an occlusive dressing in the evening and to remove the dressing in the morning (., 12-hour occlusion). When utilizing the12-hour occlusion regimen, additional cream should be applied, without occlusion, during the day. Reapplication is essential at each dressing change. If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted.

The more poignant part of this disorder is the lack of desensitization for water and aqua intile injection as allergen even on repeated exposure. [26] Avoidance of allergen as a general principle in any allergic disorder necessitates the evasion of water exposure. Topical application of antihistamines like 1% diphenhydramine before water exposure is reported to reduce the hives. [27] Oil in water emulsion creams, petrolatum as barrier agents for water can be used prior to shower or bath with good control of symptoms. [28] Therapeutic effectiveness of various classes of drugs differs from case to case.

Oral acyclovir is extremely useful in managing HSV infections in HIV-infected patients. In the immunocompetent HIV-infected patient, either intermittent or chronic suppressive therapy may be used. The immunosuppressed patient with chronic ulcerative lesions should receive acyclovir (200 to 400 mg orally 5 times daily) until the ulcers heal, which may take several weeks. Then, chronic suppressive therapy should be instituted with acyclovir (400 mg orally twice daily) to reduce recurrences. The newer acyclovir analog antiviral agents are available with better absorption and higher bioavailability. Famciclovir (250 mg 3 times daily) and valaciclovir (100 mg twice daily) are alternatives.

The role of food allergy in childhood behavior disorders is also controversial. A small subset of children with behavior disorders may be affected by food dyes, but no convincing evidence shows that food allergy plays a direct role in these disorders. 26 Unfortunately, unreliable information in the lay press and the use of unconventional and unproven methods, such as “provocation-neutralization,” 27 for diagnosing and treating behavior disorders can divert the patient's family from more useful treatments. On the other hand, in children with behavior disorder who also have bona fide allergies, treatment to relieve the symptoms of asthma, atopic dermatitis and hay fever should be pursued.

Pruritic manifestations of corticosteroid-responsive dermatoses

pruritic manifestations of corticosteroid-responsive dermatoses

The role of food allergy in childhood behavior disorders is also controversial. A small subset of children with behavior disorders may be affected by food dyes, but no convincing evidence shows that food allergy plays a direct role in these disorders. 26 Unfortunately, unreliable information in the lay press and the use of unconventional and unproven methods, such as “provocation-neutralization,” 27 for diagnosing and treating behavior disorders can divert the patient's family from more useful treatments. On the other hand, in children with behavior disorder who also have bona fide allergies, treatment to relieve the symptoms of asthma, atopic dermatitis and hay fever should be pursued.

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