Term
| What are the classes of topical steroids? |
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Definition
- Class 1 - very high potency - same as 2
- Class 2 - high potency - resistant, palms, soles
- Class 3-4 - medium potency - trunk, arms, legs
- Class 5-7 - low potency - face, genitals, armpits, folds, KIDS |
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Term
| How does formulation affect topical steroids? |
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Definition
- Ointment > cream > lotion in terms of potency
- Cream - good for most areas
- Lotion/gel/foam - area with hair, weeping areas
- Ointment - dry/scaly lesions such as sunburns |
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Term
| What are the indications for different groups of topical steroids? |
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Definition
- Groups 1 and 2 - Psoriasis, Eczema, severe poison ivy, atopic dermatitis
- Groups 3-5 - Atopic/static dermatitis, seborrheic dermatitis, tinea, scabies, facial dermatitis
- Groups 6 and 7 - dermatitis on the face, eyelids, perineum
**Use step-up therapy. |
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Term
| What are examples of low potency topical steroids? |
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Definition
- Hydrocortisone - OTC up to 1%, Rx up to 2.5%
- Desonide 0.05%
- Fluocinolone
**QD dosing is usually sufficient |
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Term
| What are examples of medium potency topical steroids? |
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Definition
- Betamethasone 0.1%
- Triamcinolone 0.025%
- Mometasone 0.1% |
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Term
| What are examples of high potency topical steroids? |
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Definition
- Triamcinolone 0.5% and above
- Topicort = Desoximetasone 0.25%
- Betamethasone AUGMENTED 0.05% |
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Term
| What are examples of very high topical steroids? |
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Definition
- Clobetasol 0.05%
- Vanos/Fluocinonide
**Do not use for greater than 2 weeks |
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Term
| What are adverse effects associated with topical steroids? |
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Definition
- Atrophy - usually on fingers
- Corticoid rosacea
- Persistent erythema
- Telangiectasia - dilated blood vessels
- Pustules
- Hypopigmentation
- Allergic dermatitis
- Tachyphylaxis, striae disease
**Systemic - HPA suppression, especially in kids. Hyperglycemia, glaucoma |
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Term
| What are guidelines for occlusion in topical steroids? |
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Definition
- Increases skin penetration
- do NOT use with very high potency (class 1)
- do NOT use for more than 12 hours/day |
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Term
| How should topical steroids be used? |
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Definition
- Cleanse area, apply, massage. Will work in 3-7 days
- A fingertip unit = 500 mg of cream/ointment and can cover one hand |
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