Derm

Question 1

What route of administration used to deliver the betamethasone to the diseased skin?

Answer 1

Betamethasone is delivered topically to the skin, the advantage is you deliver a high dose to the diseased skin but only a small amount gets absorbed into the systemic circulation

Question 2

Describe implications on possible systemic side effects on the use of topical steroids?

Answer 2

(1. ) Systemic effect of topical steroids can include hypothalamic pituitary adrenal axis suppression, cushing’s syndrome, diabetes mellitus, osteoporosis and growth retardation in children.
(2. ) H/E less than 2% of the topical steroid is absorbed systemically.

Question 3

How could we increase efficacy of topical steroids without increasing the dose?

Answer 3

(1. ) Increasing the efficacy can be achieved by changing the ‘vehicle’ of the drug, drug dissolved in an aqueous cream will be absorbed differently to one dissolved in a paraffin based ointment.
(2. ) Also using an occlusive dressing (air and watertight medical dressing) can increase the absorption by up to ten times
(3. ) Vigorous rubbing will also increase the local blood supply and increase the systemic absorption

Question 4

What other skin products may exacerbate eczema?

Answer 4

(1. ) Zerobase emollient cream can cause local skin or allergic reactions.
(2. ) Perfumed creams, shower gels or bubble baths should be discontinued.