Dermatology Case No 7. Contact Dermatitis

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Dermatology Case No 7. Contact Dermatitis

Age;34 years

(Female pt)

Duration: 10 days

Itching: present

Aggravating factors: soap,water

So,what is your dx and rx?

Answer is:

RX:-Contac dermatitis

Treatment management:-

Cream1. Dermasol N (0.5mg+5mg+1lac IU)/gm AS A (Clobetasol Propionate +Neomycin Sulphate +Nystatin) (AS A Clobetasol / Clobetasone & Combined Preparations).

Indications of Cream:- Dermasol N (0.5mg+5mg+1lac IU)/gm AS A (Clobetasol Propionate +Neomycin Sulphate +Nystatin) (AS A Clobetasol / Clobetasone & Combined Preparations).

Dermasol-N is indicated in-

Short courses treatment of recalcitrant eczemas.
Neurodermatoses.
Psoriasis (excluding widespread plaque psoriasis) where secondary bacterial infection or fungal infection is present, suspected or likely to occur.
Other inflammatory conditions which do not respond satisfactorily to less active steroids.

Pharmacology of Cream:- Dermasol N (0.5mg+5mg+1lac IU)/gm AS A (Clobetasol Propionate +Neomycin Sulphate +Nystatin) (AS A Clobetasol / Clobetasone & Combined Preparations).

Clobetasol Propionate is a very potent corticosteroid. It is prescribed to treat severe inflammatory skin disorders such as eczema and psoriasis that have not responded to weaker corticosteroids. Neomycin Sulphate is an antibiotic of the aminoglycoside type and is used to treat infections with bacteria. Nystatin is an antifungal that kills fungi and yeasts by interfering with their cell membranes. The mechanism of the topical steroids like Clobetasol, in general, is unclear. However, Clobetasol Propionate is highly active corticosteroid with topical anti-inflammatory activity. The major effect of Clobetasol Propionate on skin is a nonspecific anti-inflammatory response, partially due to vasoconstriction and decrease in collagen synthesis. Neomycin binds to the ribosomal 30s and 50s sub-units of susceptible bacteria and inhibits protein synthesis. Neomycin also causes a misreading of the genetic codes of the mRNA template and this causes incorrect amino acids to be incorporated into the growing polypeptide chain. Nystatin acts by binding to sterols in the cell membrane of the fungus with a resultant change in membrane permeability allowing leakage of intracellular components.

Side Effects of Cream:- Dermasol N (0.5mg+5mg+1lac IU)/gm AS A (Clobetasol Propionate +Neomycin Sulphate +Nystatin) (AS A Clobetasol / Clobetasone & Combined Preparations).

As with other topical corticosteroids, prolonged use of large amount or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercortisolism. The effect is more likely to occur in infants and children and if occlusive dressings are used. Prolonged and intensive treatment with highly active corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, and dilatation of the superficial blood vessels, particularly when occlusive dressings are used, or when skin folds are involved. There are reports of pigmentation changes and hypertrichosis with topical steroids.

Pregnancy & Lactation of Cream:- Dermasol N (0.5mg+5mg+1lac IU)/gm AS A (Clobetasol Propionate +Neomycin Sulphate +Nystatin) (AS A Clobetasol / Clobetasone & Combined Preparations).

There is little information to demonstrate the possible effect of topically applied Neomycin in pregnancy and lactation. However, Neomycin present in the maternal blood can cross the placenta and may give rise to a theoretical risk of foetal toxicity, thus the use of the preparation is not recommended in pregnancy and lactation. The safety of Clobetasol Propionate has not been established in lactating mothers.

Therapeutic Class of Cream:- Dermasol N (0.5mg+5mg+1lac IU)/gm AS A (Clobetasol Propionate +Neomycin Sulphate +Nystatin) (AS A Clobetasol / Clobetasone & Combined Preparations).

Clobetasol / Clobetasone & Combined Preparations

Use 2 times for 1 month

Lotion 2. Emolent (15%+6%) 25gm tube AS A (White Soft Paraffin +Liquid Paraffin) (AS A Emollients & combined preparations).

Indications of Lotion :- Emolent (15%+6%) 25gm tube AS A (White Soft Paraffin +Liquid Paraffin) (AS A Emollients & combined preparations).

For general use as an emollient in the symptomatic relief of dry skin conditions.

Pharmacology of Lotion :- Emolent (15%+6%) 25gm tube AS A (White Soft Paraffin +Liquid Paraffin) (AS A Emollients & combined preparations).

White Soft Paraffin and Liquid Paraffin are emollients with occlusive properties for topical application. There is no significant systemic absorption of the active ingredients but has substantial penetration into the stratum corneum.

Dosage & Administration of Lotion :- Emolent (15%+6%) 25gm tube AS A (White Soft Paraffin +Liquid Paraffin) (AS A Emollients & combined preparations).

Apply a thin film of the ointment to the affected area of the skin, in the direction of hair growth, as required. Repeat as necessary. Ideally the product should be applied three or four times a day or at least twice a day. In adults, where a large area of the body is affected, up to 500 g a week may be used. For topical administration only.

Side Effects of Lotion :- Emolent (15%+6%) 25gm tube AS A (White Soft Paraffin +Liquid Paraffin) (AS A Emollients & combined preparations).

Prolong use may cause folliculitis, should this occur, use of the product should be discontinued.

Pregnancy & Lactation of Lotion :- Emolent (15%+6%) 25gm tube AS A (White Soft Paraffin +Liquid Paraffin) (AS A Emollients & combined preparations).

The safety of White Soft Paraffin and Liquid Paraffin during pregnancy and lactation has not been established, but use during this periods is not considered to constitute a hazard.

Precautions & Warnings

This topical agent should be applied in the direction of hair growth to reduce the incidence of folliculitis.

Overdose Effects

This topical agent has low toxicity and if ingested treatment should be supportive and symptomatic. Gastric lavage should not be attempted following ingestion of paraffin-based products, due to the risk of inhalation or aspiration into the lungs.

Therapeutic Class of Lotion :- Emolent (15%+6%) 25gm tube AS A (White Soft Paraffin +Liquid Paraffin) (AS A Emollients & combined preparations).

Emollients & combined preparations

Use 3 times for 2 month

Tablet 3:- Cetirizine 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine).

Indications of Tablet :- Cetirizine 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine).

Cetirizine is indicated for the relief of symptoms associated with seasonal & perennial allergic rhinitis. It is also indicated for the treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria and allergen induced asthma.

Pharmacology of Tablet :- Cetirizine 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine).

Cetirizine Hydrochloride is a potent H1 receptor antagonist without any significant anticholinergic and antiserotonic effects. At pharmacologically active dose levels, it has almost no drowsiness effect and does not cause behavioral changes. It inhibits the histamine-mediated early phase of the allergic reaction and also reduces the migration of inflammatory cells and the release of mediators associated with the late phase of the allergic reaction.

Pharmacokinetics: Cetirizine 10 mg achieves peak plasma concentrations of 257 mcg/L within one hour of administration (980 mcg/L in children). Food does not affect the extent of absorption, but it may slightly reduce the rate. Peak blood levels 0.3 micrograms/ml are reached between thirty & sixty minutes after administration of 10 mg dose of Cetirizine. Its plasma half-life is approximately 11 hours. Absorption is very consistent from one subject to the next. Its renal clearance is 30 ml/minute and the excretion half-life is approximately nine hours.

Dosage & Administration of Tablet :- Cetirizine 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine).

Cetirizine oral dosage form:

Adults and Children 6 years and older: 1 tablet or 2 teaspoonfuls daily (or 1 teaspoonful twice daily).
Children 2-6 years: 1 teaspoonful once daily or 1/2 teaspoonful twice daily.
Children 6 months to 2 years : 1/2 teaspoonful once daily. The dose in children 12-23 months of age can be increased to a maximum dose as 1/2 teaspoonful every 12 hours.

Cetirizine injectable dosage form: Cetirizine is a single use injectable product for intravenous administration only. The recommended dosage regimen is one every 24 hours as needed for treatment of acute urticaria. Administer Cetirizine as an intravenous push over a period of 1 to 2 minutes. Cetirizine is not recommended in pediatric patients less than 6 years of age with impaired renal or hepatic function.

Adults and adolescents 12 years of age and older: The recommended dosage is 10 mg administered by intravenous injection.
Children 6 to 11 years of age: The recommended dosage is 5 mg or 10 mg depending on symptom severity administered by intravenous injection.
Children 6 months to 5 years of age: The recommended dosage is 2.5 mg administered by intravenous injection.

Side Effects of Tablet :- Cetirizine 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine).

The most common side effects that occurred more frequently on Cetirizine is somnolence.

Pregnancy & Lactation of Tablet :- Cetirizine 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine).

US FDA Pregnancy Category of Cetirizine Hydrochloride is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cetirizine Hydrochloride has been shown to be excreted in human milk. So, caution should be exercised when Cetirizine Hydrochloride is administered to a nursing woman.

Therapeutic Class of Tablet :- Cetirizine 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine).

Sedating Anti-histamine

0+0+1 for 15 days

Avoid soap and while powder

And water

Raiyyan Tahsan Date:19-01-2025 Sunday Time:1-35-55 PM

Raiyyan Tahsan

Raiyyan Tahsan