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topical corticosteroids

When to Scratch Beyond the Surface of the Diagnosis—A look at Atopic Dermatitis Mimickers and Their Response to Topical Corticosteroids

Teaser: 

Briar Findlay1Joseph M. Lam, MD, FRCPC,2

1 Paediatric Resident, BC Children's Hospital, Vancouver, BC.
2Associate Clinical Professor, Department of Paediatrics, Associate Member, Department of Dermatology, University of British Columbia.

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Abstract: Many dermatoses occur in the pediatric population that can mimic atopic dermatitis based on their morphology or their propensity for triggering itch. This review will highlight some of the common skin conditions that can mimic atopic dermatitis, their typical response to topical corticosteroids and helpful features that can help distinguish these conditions from atopic dermatitis.
Key Words: atopic dermatitis mimickers, topical corticosteroids, chronic inflammatory skin disease, paediatrics.
Many dermatitic eruptions can mimic atopic dermatitis but features such as their typical response to topical corticosteroids can be a helpful distinguishing feature.
Some atopic dermatitis mimickers can worsen with topical corticosteroids and these include periorificial dermatitis and tinea corporis.
Some atopic dermatitis mimickers will only partially improve with topical corticosteroids alone and these include allergic contact dermatitis and molluscum dermatitis.
Other atopic dermatitis mimickers such as psoriasis and seborrheic dermatitis can respond to topical corticosteroids and the correct diagnosis can be made using other morphological or historical features.
AD is a prevalent, chronic and relapsing condition in infancy and childhood.
Morphology, distribution and age of onset can be important in distinguishing between AD and common mimickers.
Response to corticosteroids is not diagnostic for AD as many mimickers may have an initial or complete response to topical corticosteroids; however, corticosteroid usage in some mimickers of AD may lead to complications and unnecessary side effects of topical corticosteroids.
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Related Terms: Dermatology, atopic dermatitis mimickers, topical corticosteroids, chronic inflammatory skin disease, paediatrics
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A Strange Looking Rash That Does Not Respond to Topical Corticosteroids

A Strange Looking Rash That Does Not Respond to Topical Corticosteroids

Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.

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Teaser: 

Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.

Abstract
Tinea incognito is a superficial dermatophyte infection in which the clinical appearance of the symptoms has been altered by inappropriate treatments, such as topical corticosteroids.
Dermatophyte infection may result from contact with infected humans, animals, or inanimate objects. An erythematous, pruritic, annular and scaly plaque is characteristic of a symptomatic infection. A potassium hydroxide (KOH) examination of skin scrapings is usually diagnostic. If topical corticosteroids have been applied recently, the amount of surface scales may be reduced and may lead to false negative results. Topical therapy is the first line treatment for localized infections. Systemic antifungals should be used in extensive condition, immunosuppression, resistance to topical antifungal therapy.

Related Terms: Dermatology, topical corticosteroids, Tinea incognito, dermatophytoses, fungus, trichophyton rubrum

Top Ten Tips for Atopic Tots

Top Ten Tips for Atopic Tots

Teaser: 

Katia Faustini, Faculty of Medicine, McGill University, Montreal, Quebec.
Joseph M Lam, MD, FRCP(C), Clinical Assistant Professor, Department of Pediatrics, Associate Member, Department of Dermatology and Skin Sciences, University of British Columbia.

Abstract
Atopic dermatitis is the most common inflammatory skin condition affecting children. Given the complex waxing and waning nature of this common dermatologic condition, patient education and frequent family physician involvement, is the key to proper long term management. While topical steroids have long been accepted as the standard therapy in management of eczema, concern over its side effects by both family doctors and patients greatly impact compliance. Topical steroids are safe and efficacious if used properly. This article examines the top ten things to know about atopic dermatitis in order to properly and safely manage this chronic disease.
Keywords: atopic dermatitis, inflammatory skin condition, topical corticosteroids.

Related Terms: Dermatology, atopic dermatitis, inflammatory skin condition, topical corticosteroids