Dermatology Case No 28. Lichen Simplex Chronicus

Hello I'm Raiyyan Tahsan

Brand Model and Executive

Dermatology Case No 28. Lichen Simplex Chronicus

Type of Eczema.

Rax- Cream 1. Dermasol 0.05% (AS A Clobetasol Propionate AS A Other Topical corticosteroids).BD dose for 4 weeks,

Indications of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Dermasol is indicated for adults, elderly and children over 1 year in following dermatoses.

Psoriasis (excluding widespread plaque psoriasis)
Recalcitrant dermatoses
Lichen planus
Discoid lupus erythematosus
Other skin conditions which do not respond satisfactorily to less potent steroids.

Composition of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Clobetasol Propionate Cream: Each gram cream contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Ointment: Each gram ointment contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Scalp Application: Each gram lotion contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Shampoo: Each gram shampoo contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Lotion: Each gram lotion contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Spray: Each gram spray contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Pharmacology of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid.

Dosage of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Cream, Ointment: Adults, elderly and children over 1 year: Apply a thin layer of Clobetasol Propionate Cream or Ointment to the affected skin areas twice daily and rub in gently and completely. Repeated short courses of Clobetasol Propionate may be used to control exacerbations. In more resistant lesions, especially where there is hyperkeratosis, the effect of Clobetasol can be enhanced, if necessary, by occluding the treatment area with polythene film. Overnight occlusion only is usually adequate to bring about a satisfactory response.

Clobetasol Propionate is super-high potency topical corticosteroids; therefore, treatment should be limited to 2 consecutive weeks. The maximum weekly dose should not be exceeded 50 gm/week. In case of children, courses should be limited if possible to five days and reviewed weekly.

Spray: Apply required quantity of spray of once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Propionate scalp solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Propionate scalp solution for brief periods only.

Shampoo: It should be applied to the dry (not wet) scalp once a day to the affected areas only. It should be massaged gently into the lesions and left in place for 15 minutes before lathering and rinsing. Treatment should be limited to 4 consecutive weeks. Total dosage of shampoo should not exceed 50 g per week. Under 18 years this preparation is not recommended.

Scalp Solution: Apply required quantity of spray of Clobetasol Scalp Solution once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Scalp Solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Scalp Solution for brief periods only.

Administration of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Route of administration: Cutaneous. Creams are especially appropriate for moist or weeping surfaces. Ointments are especially appropriate for dry, lichenified or scaly lesions.

Interaction of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Co-administered drugs that can inhibit CYP3A4 (eg ritonavir, itraconazole) have been shown to inhibit the metabolism of corticosteroids leading to increased systemic exposure.

Contraindications

Rosacea, acne vulgaris and perioral dermatitis. Primary cutaneous viral infections (e.g. herpes simplex, chickenpox).
Hypersensitivity to the preparation.
The use of Clobetasol Propionate skin preparations is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi (e.g. candidiasis, tinea), or bacteria (e.g.impetigo): perianal and genital pruritus.
Dermatoses in children under one year of age, including dermatitis and napkin eruptions.

Side Effects of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

As with other topical corticosteroids prolonged use of large amounts, or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercorticism.
Prolonged and intensive treatment with a highly active corticosteroid preparation 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.
In rare instances, treatment of psoriasis with corticosteroids (or its withdrawal) is thought to have provoked the pustular form of the disease.
There are reports of pigmentation changes and hypertrichosis with topical steroids. Dermasol is usually well tolerated, but if signs of hypersensitivity appear, application should be stopped immediately. Exacerbation of symptoms may occur.

Pregnancy & Lactation

There are limited data from the use of Clobetasol Propionate cream in pregnant women. Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development. The relevance of this finding to humans has not been established. However, the administration of Clobetasol Propionate Cream during pregnancy and lactation should only be considered if the expected benefit to the mother outweighs the possible risks of treatment.

It is unknown whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Clobetasol Propionate Cream is administered to a nursing woman.

Precautions & Warnings

Long-term continuous topical therapy should be avoided where possible, particularly in infants and children, as adrenal suppression can occur readily even without occlusion. If used in childhood or on the face, courses should be limited if possible to five days and occlusion should not be used.

The face, more than other areas of the body, may exhibit atrophic changes after prolonged treatment with potent topical corticosteroids. This must be borne in mind when treating such conditions as psoriasis, discoid lupus erythematosus and severe eczema.

If applied to the eye lids, care is needed to ensure that the preparation does not enter the eye, as glaucoma or cataract might result.

Topical corticosteroids may be hazardous in psoriasis for a number of reasons including rebound relapses, development of tolerance, risk of generalised pustular psoriasis and development of local or systemic toxicity due to impaired barrier function of the skin. If used in psoriasis careful patient supervision is important.

Appropriate anti-microbial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of anti-microbial agents. Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressings, and so the skin should be cleansed before a fresh dressing is applied.

Use in Special Populations of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

In infants and children under 12 years of age, long-term continuous topical corticosteroid therapy should be avoided where possible, as adrenal suppression can occur. Children are more susceptible to the use of topical corticosteroids which develops atrophic changes.

Overdose Effects of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Acute overdosage is very unlikely to occur, however, in the case of chronic over-dosage or misuse the features of hypercortisolism may occur and in this situation topical steroid should be discontinued.

Therapeutic Class of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS A Other Topical corticosteroids).

Indications of Cream:-Emolent [15%+6% ] (As A White Soft Paraffin + Liquid Paraffin As A Emollients & combined preparations) 25gm Tube

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

Pharmacology of Cream:-Emolent [15%+6% ] (As A White Soft Paraffin + Liquid Paraffin As A Emollients & combined preparations) 25gm Tube

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 Cream:-Emolent [15%+6% ] (As A White Soft Paraffin + Liquid Paraffin As A Emollients & combined preparations) 25gm Tube

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 Cream:-Emolent [15%+6% ] (As A White Soft Paraffin + Liquid Paraffin As A Emollients & combined preparations) 25gm Tube

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

Pregnancy & Lactation

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 of Cream:-Emolent [15%+6% ] (As A White Soft Paraffin + Liquid Paraffin As A Emollients & combined preparations) 25gm Tube

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 Cream:-Emolent [15%+6% ] (As A White Soft Paraffin + Liquid Paraffin As A Emollients & combined preparations) 25gm Tube

Emollients & combined preparations

Salicid 6%,

Cream 1: Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

রাতে একবার (১ মাস) 30gm tube.

Indications of Cream 1: Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

6% Kerasol: This topical preparations treat the following common scaly conditions:

Chronic atopic dermatitis
Lichen simplex
Psoriasis
Seborrhoeic dermatitis
Ichthiosis

12% Kerasol: This topical preparations treat the following common scaly conditions:

Warts (small excessive growths of skin caused by a type of virus. Warts often occur on the fingers or on the back of the hands).
Verruca (occurs only on the sole of the feet and can be painful. It often looks like a small white ring of skin with a black dot in the centre).
Corns and Calluses (are hard, thick pads of skin caused by pressure and friction. They usually occur on the feet due to poorly fitting shoes and can occur on the hands).

2% Kerasol: This topical preparation is indicated in-

Mild to moderate acne
Blackheads and whiteheads
Redness & swelling of face
Pimples
To prevent future acne breakouts

Description of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

Kerasol is available by prescription only as a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders including verrucae and the various ichthyoses (vulgaris, sex-linked and lamellar), keratosis palmaris and plantaris, keratosis pilaris, pityriasis rubra pilaris and psoriasis (including body, scalp, palms and soles).

Pharmacology of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

Salicylic Acid has a potent keratolytic & a slight antiseptic action when applied topically to the skin. In low concentrations, the drug has keratoplastic activity (correction of abnormal keratinization) & in higher concentrations, the drug has keratolytic activity (causes peeling of skin). Salicylic Acid softens & destroys the stratum corneum by increasing endogenous hydration (water concentration), probably because of decreased pH, which causes the cornified epithelium (horny layer of the skin) to swell, soften, & then desquamate. Necrosis of normal skin has been associated with overuse of the drug. At high concentrations, Salicylic Acid has a caustic effect. Moisture is essential for Salicylic Acid to exert its action on the skin and for maceration and desquamation of epidermal tissue to occur. The drug has weak antifungal & antibacterial activity.

Dosage & Administration of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

6% & 12% Salicylic Acid: Apply to affected area once daily. Hydrate area for 5 minutes prior to application if possible. Occlude the area at night. Wash off in morning. Salicylic Acid is used in children over 2 years.

2% Salicylic Acid: Apply enough medicine to cover the affected area once daily in 1st week then 2 to 3 times daily from 2nd week and rub gently. After 3-5 minutes rinse face with cool water. Salicylic Acid is used in children over 2 years.

Interaction of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

Do not use other topical preparations on the treated area unless otherwise directed by your healthcare provider. They may interfere with treatment or increase skin irritation.

Contraindications of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

It should not be used in any patient known to be sensitive to Salicylic Acid or any other listed ingredients.

Side Effects of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

An allergic reaction (shortness of breath, closing of the throat, swelling of the lips, face or tongue or hives) or severe skin irritation.

Pregnancy & Lactation of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

Pregnancy Category C. If used by nursing mothers, it should not be used on the chest area to avoid accidental contamination of the child.

Precautions & Warnings

For external use only. Avoid contact with eyes and other mucous membranes.

Overdose Effects of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

An overdose of Kerasol topical is unlikely to occur. If the medication has been ingested or an overdose is suspected, the patient needs to be hospitalized immediately.

Therapeutic Class of Cream : Kerasol 6% (As A salicylic Acid As A Topical salicylic preparation).

Topical salicylic preparation

Or Ointment 1:Dermasol plus As A 0.05%+3% (Clobetasol Propionate + Salicylic Acid) As A Clobetasol / Clobetasone & Combined Preparations.

General Queries:

1.topical steroids 3weeks besi tana deoa jay?

Answer is:1 session e 4 weeks porjonto use kora jai Raiyyan Tahsan

Raiyyan Tahsan Date:28-01-2025 Tuesday Time:-12-53-33 PM

Raiyyan Tahsan

Raiyyan Tahsan