The Use and Abuse of Topical Corticosteroids

1977 ◽  
Vol 63 (1) ◽  
pp. 18-25
Author(s):  
M. D. Catterall
Keyword(s):  
Side Effects ◽  
Topical Corticosteroid ◽  
Corticosteroid Therapy ◽  
Rank Order ◽  
Topical Corticosteroids ◽  
Systemic Side Effects

AbstractA rationalised approach to topical corticosteroid therapy is presented. Factors which influence the choice of preparation are considered, based upon the concept of ’rank order ’, for both halogenated and non-halogenated steroids. Practical considerations, including choice of base, polythene occlusion and tachyphylaxis are discussed and local and systemic side effects considered in detail.

scholarly journals Systemic side-effects of topical corticosteroids

2014 ◽  
Vol 59 (5) ◽  
pp. 460 ◽  
Author(s):  
Sandipan Dhar ◽  
Joly Seth ◽  
Deepak Parikh
Keyword(s):  
Side Effects ◽  
Topical Corticosteroids ◽  
Systemic Side Effects

Flexible Classification for the Clinical Potency of Topical Corticosteroid Proprietaries

1988 ◽  
Vol 22 (5) ◽  
pp. 412-415
Author(s):  
Ramon M. Fusaro
Keyword(s):  
Side Effects ◽  
Product Development ◽  
Topical Corticosteroid ◽  
New Product Development ◽  
New Product ◽  
Relative Potency ◽  
Flexible System ◽  
Systemic Side Effects

A flexible system of classifying topical corticosteroid proprietaries is proposed to help the clinician understand the relative antiinflammatory potency of these products. This system has the advantage of indicating not only the relative potency of a specific proprietary preparation but also noting the number of divisions in the classification. It allows for new product development and keeps the clinician informed of the change by the number of divisions being used. The system also has the potential for the classification of relative severity of both local and systemic side effects of corticosteroids.

scholarly journals CLINICAL PROFILES OF VITILIGO WITH NARROWBAND UVB AND TOPICAL CORTICOSTEROID THERAPY AT DR. SOETOMO HOSPITAL

2020 ◽  
Vol 8 (1) ◽  
pp. 8
Author(s):  
Sarah Fauzia ◽  
Rahmadewi Rahmadewi ◽  
Dyah Fauziah
Keyword(s):  
Topical Corticosteroid ◽  
Corticosteroid Therapy ◽  
Disease Onset ◽  
Treatment Preference ◽  
Uvb Radiation ◽  
Affected Area ◽  
Topical Corticosteroids ◽  
Multiple Lesions ◽  
Narrowband Uvb ◽  
Clinical Profiles

Background: Vitiligo is a depigmenting disorder that causes a loss of melanocytes in the epidermis. Treatment preferences are based on the characteristics of the vitiligo lesions. Purpose: This study evaluates the clinical profiles of vitiligo treated with narrowband UVB (NB-UVB) and topical corticosteroid therapy in Dr. Soetomo Hospital in 2017. Methods: This study is a retrospective study that uses data from the medical records of vitiligo patients who were treated with NB-UVB and topical corticosteroids in Dr. Soetomo Hospital in 2017. The dependent variable was vitiligo treated with NB-UVB radiation or topical corticosteroids, while the independent variables were disease onset, precipitating factor, duration, stability, amount, affected area, location, and type of vitiligo. Results: Thirty-seven patients (19 females) were included, four of whom had been treated with NB-UVB and 33 with topical corticosteroids. In the NB-UVB group, 75% had stable lesions, 50% had a single lesion, 50% had multiple lesions, 75% had an affected area <10cm2, 40% had lesions around their face, 40% had lesions on their extremities, and 75% had focal vitiligo. In the topical corticosteroids group, 76% had active lesions, 82% had multiple lesions, 82% had an affected area <10 cm2, 28% had lesions around their upper extremities, 28% had lesions around their lower extremities, and 46% had segmental vitiligo. Conclusion: Treatment preference in Dr. Soetomo Hospital 2017 was indicated by the patients’ clinical profiles.

scholarly journals Labial Veneers in the Management of Desquamative Gingivitis: Report of a Case

2004 ◽  
Vol 5 (4) ◽  
pp. 122-132 ◽  
Author(s):  
Rampalli Viswa Chandra ◽  
Pratibha Pandurang ◽  
Khandige Mahalinga Bhat
Keyword(s):  
Topical Corticosteroid ◽  
Corticosteroid Therapy ◽  
Gingival Tissue ◽  
Topical Corticosteroids ◽  
Custom Made ◽  
Attached Gingiva

Abstract Desquamative gingivitis is a condition characterized by intense erythema, ulceration, and desquamation of the free and attached gingiva. Approximately 50% of desquamative gingivitis cases occur on the gingival tissues though it is not uncommon at other intraoral and extraoral sites. Though topical corticosteroids are considered the mainstays in the treatment of desquamative gingivitis, the inability of these medicaments to be in contact with the affected sites for longer duration has been implicated as a factor in reducing the efficacy of this mode of treatment. The case presented here is of a 24-year old male with desquamative gingivitis of 3 years duration. Topical corticosteroid therapy using custom-made acrylic veneers was utilized in the patient with remarkable results. This paper highlights the use of acrylic labial veneers over the gingival tissue as a vehicle for delivering medication and as a way to improve aesthetics. Citation Chandra RV, Pandurang P, Bhat KM. Labial Veneers in the Management of Desquamative Gingivitis: Report of a Case. J Contemp Dent Pract 2004 November;(5)4:122-132.

Revisited: Aerosol Corticosteroids in the Treatment of Childhood Asthma

PEDIATRICS ◽  
1983 ◽  
Vol 72 (1) ◽  
pp. 130-131
Author(s):  
GARY S. RACHELEFSKY ◽  
SHELDON C. SIEGEL
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Corticosteroid Therapy ◽  
Childhood Asthma ◽  
Treatment Modality ◽  
Duration Of Therapy ◽  
Systemic Corticosteroids ◽  
Inappropriate Treatment ◽  
Systemic Side Effects ◽  
The 1950S

Systemic corticosteroids were introduced in the 1950s for the treatment of asthma. Usually, excellent results were obtained although a number of side effects became apparent. Prolonged use of corticosteroid therapy for asthma remains quite controversial, and it is often regarded as an inappropriate treatment modality. Inasmuch as complications from corticosteroids are largely dependent on dose and duration of therapy, it was reasoned that by topically administering the corticosteroids, the amount of drug necessary to control symptoms would be reduced and, in turn, lessen the number of adverse effects. Initially developed corticosteroid aerosols produced variable effectiveness with associated systemic side effects.1

scholarly journals Recent advances in understanding NRF2 as a druggable target: development of pro-electrophilic and non-covalent NRF2 activators to overcome systemic side effects of electrophilic drugs like dimethyl fumarate

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2138 ◽  
Author(s):  
Takumi Satoh ◽  
Stuart Lipton
Keyword(s):  
Side Effects ◽  
Specific Interaction ◽  
Dimethyl Fumarate ◽  
Carnosic Acid ◽  
European Medicines Agency ◽  
Related Factor ◽  
Inflammatory Phase ◽  
First Case ◽  
Systemic Side Effects ◽  
Transcriptional Pathway

Dimethyl fumarate (DMF) is an electrophilic compound previously called BG-12 and marketed under the name Tecfidera®. It was approved in 2013 by the US Food and Drug Administration and the European Medicines Agency for the treatment of relapsing multiple sclerosis. One mechanism of action of DMF is stimulation of the nuclear factor erythroid 2-related factor 2 (NRF2) transcriptional pathway that induces anti-oxidant and anti-inflammatory phase II enzymes to prevent chronic neurodegeneration. However, electrophiles such as DMF also produce severe systemic side effects, in part due to non-specific S-alkylation of cysteine thiols and resulting depletion of glutathione. This mini-review presents the present status and future strategy for NRF2 activators designed to avoid these side effects. Two modes of chemical reaction leading to NRF2 activation are considered here. The first mode is S-alkylation (covalent reaction) of thiols in Kelch-like ECH-associated protein 1 (KEAP1), which interacts with NRF2. The second mechanism involves non-covalent pharmacological inhibition of protein-protein interactions, in particular domain-specific interaction between NRF2 and KEAP1 or other repressor proteins involved in this transcriptional pathway. There have been significant advances in drug development using both of these mechanisms that can potentially avoid the systemic side effects of electrophilic compounds. In the first case concerning covalent reaction with KEAP1, monomethyl fumarate and monoethyl fumarate appear to represent safer derivatives of DMF. In a second approach, pro-electrophilic drugs, such as carnosic acid from the herb Rosmarinus officinalis, can be used as a safe pro-drug of an electrophilic compound. Concerning non-covalent activation of NRF2, drugs are being developed that interfere with the direct interaction of KEAP1-NRF2 or inhibit BTB domain and CNC homolog 1 (BACH1), which is a transcriptional repressor of the promoter where NRF2 binds.

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