Derm (Eczema, Psoriasis, Alopecia, Acne)

Question 1

List the topical and systemic treatment options for eczema

Answer 1

Topical:
1. TCS (desonide, hydrocort, betamet val, mometasone, betamet prop)
2. TCI (pimecrolimus, tacrolimus)
3. moisturizers
4. Fusicort (fusidic acid)
5. Fucidin-H
* antibiotic-containing products for broken skin

Systemic:
Non-biologics:
1. MTX
2. cyclosporine
3. JAK-i (DMARDs): baricitinib, upadacitinib

Biologics:
1. dupilumab

Question 2

What are the common side effects of TCIs? how to manage?

Answer 2

Skin irritation & burning sensation initially which should get better when skin heals.
Can place tube of cream in fridge 10-15 mins before application for cooling effect; If still unable to tolerate, can reduce freq of application: BD=>OD; OD=>EOD

irritation effect is worse when skin is broken

Question 3

What’s the difference of pimecrolimus VS tacrolimus?

Answer 3

Tacrolimus for moderate~severe, Pimecrolimus for mild~moderate eczema

Skin irritation should be less w/ pime