Steroid induced rosacea accutane effect

Leprosy is a chronic infection of skin and peripheral nerves caused by Mycobacterium leprae . Almost 4 million people have been affected by leprosy and nearly 250,000 new cases are still being detected annually throughout the world. WHO recommended multidrug therapy (MDT) which has been the mainstay of treatment for leprosy and in reducing its prevalence to near elimination levels. However, lepra reactions and nerve damage cause significant morbidity among patients affected with leprosy. Apart from well-established treatment with systemic corticosteroids and thalidomide, and many anti-inflammatory and immunomodulator drugs, oral zinc has been found useful in the management of lepra reactions owing to its immunostimulatory properties. Zinc is found to stimulate production of IL-2 and induces a shift from Th2 to Th1 response. It has also been demonstrated to decrease the serum levels of TNF- α and inhibit the TNF- α induced apoptosis of peripheral blood mononuclear cells that helps in controlling the disease activity and reactional states [ 14 ]. In a study comprising patients of recurrent erythema nodosum leprosum additionally receiving zinc, the steroids could be tapered off completely and the duration and severity of reaction were also reduced [ 15 ]. Addition of oral zinc to antileprosy treatment too has been shown to improve therapeutic outcome. Oral zinc when given as an adjuvant to dapsone in lepromatous leprosy induced rapid lepromin conversion and bacterial clearance in the patients as compared to the control group. The clinical improvement was also faster in patients receiving zinc as an adjuvant along with standard MDT [ 16 ]. Oral zinc perhaps makes an adjuvant of choice in leprosy treatment.

Prescriptions written for topical steroids should include explicit instructions about where and how often to apply the preparation, and the body areas where use must be avoided.  Pharmacists should ensure these directions are included on the dispensing label.  Prescribers should bear in mind that patients may keep unused or leftover corticosteroid skin preparations for some time after they are prescribed and thus forget the original indication or instructions for use.  The prescribing of unnecessarily large quantities should be avoided.  Patients should be warned not to share their topical steroid preparation with other people as this may result in unsafe application to unsuitable areas such as the face, as well as the potentially inappropriate treatment of undiagnosed skin conditions.

Oral steroids ( prednisone , [ Medrol ]) can help severe cases of hives in the short term, but their usefulness is limited by the fact that many cases of hives last too long for steroid use to be continued safely. Other treatments have been used for urticaria as well, including montelukast ( Singulair ), ultraviolet radiation , antifungal antibiotics, agents that suppress the immune system, and tricyclic antidepressants ( amitriptyline [ Elavil , Endep ], nortriptyline [ Pamelor , Aventyl], doxepin [Sinequan, Adapin]). Evidence to support the benefit of such treatments is sparse. In ordinary cases, they are rarely needed. A new treatment recently available for chronic urticaria is the monthly subcutaneous injection of a monoclonal antibody, omalizumab ( Xolair ), directed against the IgE receptor on human mast cells.

ABSTRACT: Numerous cutaneous manifestations have been associated with use of BRAF inhibitors, including two previously reported cases of granuloma annulare (GA) eruptions associated with vemurafenib therapy. Both of these patients were being treated for metastatic melanoma. In this report, we describe the case of a 71-year-old man who developed classic GA lesions while being treated with vemurafenib monotherapy for nonmelanoma cancer, specifically metastatic lung adenocarcinoma positive for BRAF V600 mutation. J Drugs Dermatol. 2017;16(10):1050-1052.

Steroid induced rosacea accutane effect

steroid induced rosacea accutane effect

ABSTRACT: Numerous cutaneous manifestations have been associated with use of BRAF inhibitors, including two previously reported cases of granuloma annulare (GA) eruptions associated with vemurafenib therapy. Both of these patients were being treated for metastatic melanoma. In this report, we describe the case of a 71-year-old man who developed classic GA lesions while being treated with vemurafenib monotherapy for nonmelanoma cancer, specifically metastatic lung adenocarcinoma positive for BRAF V600 mutation. J Drugs Dermatol. 2017;16(10):1050-1052.

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