Skin

Question 1

What are the indications for topical corticosteroids (glucocorticoids)?

Answer 1

Used in inflammatory skin conditions e.g. eczema, to treat disease flares or to control chronic disease where emollients alone are ineffective.

Question 2

How do corticosteroids have their effects on skin?

Answer 2

Corticosteroids have immunosuppresant, metabolic and mineralcorticoid effects. Where they are applied topically, effects are mostly limited to the site of application.

Question 3

What are the adverse effects of corticosteroids?

Answer 3

Adverse effects are uncommon with mild or moderately potent topical corticosteroids (hydrocortisone 0.1-2.5% is mild). However potent (betamethasone valerate 0.1% is potent) and very potent topical corticosteroids can cause local adverse effects such as skin thinning, striae (stretch marks), telangiectasia (Telangiectasia is a condition in which widened venules (tiny blood vessels) cause threadlike red lines or patterns on the skin) and contact dermatitis.

Question 4

Half a finger tip unit is enough cream or ointment to cover what corresponding region of space?

Answer 4

one palm size

Question 5

What are emollients used for?

Answer 5

Dry skin disorders, they work by replacing water content in dry skin.
They contain oils or paraffin-based products that help to soften the skin and can reduce water looss by protecting against evaporation from the skin surface.

Many can be used as a soap substitute (as soap is drying to the skin).

Question 6

Why can emollients exacerbate acne vulgaris and folliculitis?

Answer 6

By blocking pores and hair follicles.

Question 7

What is the main adverse effect of emollients?

Answer 7

They cause greasy skin but this is integral to their therapeutic effect.

Question 8

What is the main risk of using parafin-based emollients where the oil content is high (>50%)?

Answer 8

They are a significant fire hazard and if accumulation into bedding or clothing occurs become a significant fire risk.