Dermatology: Corticosteroids

Question 1

What is the MOA of corticosteroids?

Answer 1

antimimotic effects of epidermis

Ex: psoriasis where there is increased cell turnover.

Question 2

Corticosteroids are minimally absorbed when applied to normal skin.

T/F?

Answer 2

TRUE

Question 3

When is there a 10 fold increase in absorption with corticosteroids?

Answer 3

When you occlude it with a plastic wrap to enhance penetration.

Question 4

Does penetration of corticosteroids increase in inflamed skin or normal skin?

Answer 4

Inflamed skin (atopic dermatitis) and exfoliative diseases

Question 5

What is the potency of Class I of corticosteroids?

Where are they used?

What are some examples of these types of corticosteroids?

Answer 5

Super high potency

Used for severe dermatoses over nonfacial and nonintertriginous areas like:

SCALP
PALMS
SOLES
THICK PLAQUES on extensor surfaces

Examples:

Clobetasol Propionate 0.05% cream or ointment

Question 6

What is the potency of (Classes II-V) of corticosteroids?

Where are they used?

What are some examples of these types of corticosteroids?

Answer 6

medium to high potency

mild-moderate nonfacial and nonintertriginous areas

use on flexural suraces for limited periods

EXAMPLES:

Betamethasone dipropionate 0.05% cream

Fluocinonide 0.05% cream, gel, pointment, or Na

Betamethasone valerate 0.1% ointment

Triamcinolone acetonide 0.1% ointmnet

Fluocinolone acetonide 0.025% cream

Question 7

What is the potency of (Classes VI, VII) of corticosteroids?

Where are they used?

What are some examples of these types of corticosteroids?

Answer 7

Low potency steroids

used for large areas and on thinner skins

Face, eyelid, genital and intertriginous areas

EXAMPLES:

flucinolone acetonide

triamcinolone acetonide cream

hydrocortisone 1%

Question 8

What are the systemic side effects of Topical Glucocorticoid Therapy?

Answer 8

oral steroids: suppresses HPA axis

• cushing’s syndrome
• psuedotumor cerebri
• growth retardation
• Na retention and edema

Question 9

Ocular Side Effects of Topical Glucocorticoid Therapy

Answer 9

• cataract
• glaucoma
• retarded healing of corneal abrasion
• extension of herpetic infection
• increased susceptibility to bacterial and fungal infection

Question 10

Cutaneous side effects of Topical glucocorticoid Therapy?

Answer 10

• epidermal and dermal atrophy
• striae disease
• telangiectasis
• purpura & ecchymosis
• hypopigmentation
• retardation of wound healing
• contact allergic dermatitis GC-induced (rare), vehicle-induced (common)
• topical GC habituation