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topical steroid withdrawal

Nicholas Cook, Fizza Mushtaq, Christina Leitner, Andrew Ilchyshyn, George T Smith, Ian A Cree
BACKGROUND: Toxicity is rarely considered in the differential diagnosis of conjunctivitis, but we present here a new form of toxic conjunctivitis with unusual clinical features. Between 2010 and 2013, a new clinical presentation of chronic conjunctivitis unresponsive to normal treatment was noted within a Primary Care Ophthalmology Service. METHODS: Retrospective review of case records and histopathology results. RESULTS: A total of 55 adult patients, all females, presented with epiphora and stickiness...
2016: BMC Ophthalmology
Ikuko Yataba, Noboru Otsuka, Isao Matsushita, Hideo Matsumoto, Yuichi Hoshino
OBJECTIVES: S-flurbiprofen plaster (SFPP) is a novel non-steroidal anti-inflammatory drug (NSAID) patch, intended for topical treatment for musculoskeletal diseases. This trial was conducted to examine the effectiveness of SFPP using active comparator, flurbiprofen (FP) patch, on knee osteoarthritis (OA) symptoms. METHODS: This was a phase III, multi-center, randomized, adequate, and well-controlled trial, both investigators and patients were blinded to the assigned treatment...
May 11, 2016: Modern Rheumatology
Lee Yee Chong, Karen Head, Claire Hopkins, Carl Philpott, Martin J Burton, Anne G M Schilder
BACKGROUND: This review is one of six looking at the primary medical management options for patients with chronic rhinosinusitis.Chronic rhinosinusitis is common and is characterised by inflammation of the lining of the nose and paranasal sinuses leading to nasal blockage, nasal discharge, facial pressure/pain and loss of sense of smell. The condition can occur with or without nasal polyps. Topical (intranasal) corticosteroids are used with the aim of reducing inflammation in the sinonasal mucosa in order to improve patient symptoms...
2016: Cochrane Database of Systematic Reviews
Birsen Sahıp, Mehmet Celık, Semra Ayturk, Ahmet Kucukarda, Onur Mert, Nejla Dıncer, Sıbel Guldıken, Armagan Tugrul
Glucocorticoids are used for the treatment of many diseases, such as inflammatory, allergic, autoimmune, and neoplastic diseases. They can be used in the form of topical, oral, inhalable, rectal, and intra-articular agents. Many topical steroid-related iatrogenic Cushing's syndrome cases affecting especially children have been reported in the literature. Topical steroid-related Cushing's syndrome is rarely seen in adults. In this report, we present the case of a 32-year-old male patient with iatrogenic Cushing's syndrome related to long-term clobetasol propionate treatment for psoriasis...
January 2016: Indian Journal of Dermatology
Justin Gabriel Schlager, Stefanie Rosumeck, Ricardo Niklas Werner, Anja Jacobs, Jochen Schmitt, Christoph Schlager, Alexander Nast
BACKGROUND: People with chronic plaque psoriasis often have lesions on the scalp. Hair makes the scalp difficult to treat and the adjacent facial skin is particularly sensitive to topical treatments. OBJECTIVES: To assess the efficacy and safety of topical treatments for scalp psoriasis. SEARCH METHODS: We searched the following databases up to August 2015: the Cochrane Skin Group Specialised Register, CENTRAL (2015, Issue 7), MEDLINE (from 1946), EMBASE (from 1974) and LILACS (from 1982)...
February 26, 2016: Cochrane Database of Systematic Reviews
Sonja Vuč Ković, Katarina Savić Vujović, Dragana Srebro, Branislava Medić, Tatjana Ilic-Mostic
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for the treatment of pain, inflamation and fever. They are usually well tolerated in healthy persons, but in patients with risk factors (advanced age, renal impairment, heart failure, liver disease, concurrent medications with antihypertensive drugs), NSAIDs can induce serious renal adverse effects. They include sodium and water retention with edema, worsening of heart failure, hypertension, hyponatremia, hyperkalemia, acute kidney injury, chronic kidney disease, renal papillary necrosis and acute interstitial nephritis...
2016: Current Medicinal Chemistry
Mototsugu Fukaya
INTRODUCTION: Though topical steroid addiction (TSA) in patients with atopic dermatitis (AD) has been recently discussed as a clinical problem, there are very few studies about its mechanism. The purpose of this study was to elucidate histological and immunohistological characteristics of TSA using anti-cortisol antibody. METHODS: Skin biopsy specimen from eight patients with AD was stained by anti-cortisol antibody (Biorbyt, orb79379). Subjects consisted of a child patient with a short history of topical corticosteroids (TCS) application, an adult patient with a long history of TCS application, and six adult patients who have experienced topical steroid withdrawal (TSW) and the rebound phenomenon...
March 2016: Dermatology and Therapy
Wan-Yi Chou, Chih-Jung Hsu
Currently, tumor necrosis factor alpha (TNF-alpha) inhibitors are widely used for many autoimmune disorders. However, they cause an immunocompromised status that sometimes leads to many cutaneous side effects including atypical infections. Herein, we report the first case of adalimumab-related Majocchi's granuloma.A 43-year-old Taiwanese male patient with chronic plaque-type psoriasis developed numerous tender nodules 1 month after adalimumab injection. The nodules responded poorly to bacterial folliculitis treatment...
January 2016: Medicine (Baltimore)
S El-Heis, D A Buckley
Topical calcineurin inhibitors have been used outside their approved indications for a number of conditions, including topical steroid-induced rosacea. However, tacrolimus ointment itself has been reported to trigger rosacea in a small number of cases. We report a case of a rosacea-like eruption in a 39-year-old woman occurring after the use of pimecrolimus cream for 12 months for atopic dermatitis. Withdrawal of pimecrolimus combined with treatment with oral lymecycline, topical metronidazole, and an emollient resulted in resolution of the eruption...
May 2015: Dermatology Online Journal
Ramnik V Patel, Marina Brimioulle, Dhaval Govani, Talaat Youssef
We report a case of juvenile allergic urethritis secondary to double concentrate orange squash of a famous brand in a 3-year-old boy who developed bilateral urethro-ejaculatory reflux (UER) and severe urethral, perineal and scrotal pain referred to both lower limbs intermittently predominantly during and after micturition-simulating features of bilateral intermittent testicular torsion. Accurate history, urinalysis, ultrasound, colour Doppler and food challenge were helpful in diagnosis. Topical steroids, antihistaminic, analgesic and anti-inflammatory medications together with withdrawal of the allergen produced complete recovery...
2015: BMJ Case Reports
J R Diaz-Siso, S Fischer, G C Sisk, E Bueno, M Kueckelhaus, S Talbot, M J Carty, N S Treister, F Marty, E L Milford, B Pomahac, S G Tullius
Current immunosuppression in VCA is largely based on the experience in solid organ transplantation. It remains unclear if steroids can be reduced safely in VCA recipients. We report on five VCA recipients who were weaned off maintenance steroids after a median of 2 months (mean: 4.8 months, range 2-12 months). Patients were kept subsequently on a low dose, dual maintenance consisting of tacrolimus and mycophenolate mofetil/mycophenloic acid with a mean follow-up of 43.6 months (median = 40 months, range 34-64 months)...
May 2015: American Journal of Transplantation
Savleen Kaur, Indu Dhiman, Sushmita Kaushik, Srishti Raj, Surinder S Pandav
PURPOSE: The aim of our study was to analyze the epidemiological profile and outcome of steroid-induced ocular hypertension in children below 12 years of age in a tertiary eye center. METHODS: Hospital records of patients attending the pediatric glaucoma clinic from July 2005 to December 2012 at our center were retrospectively reviewed. Steroid-induced ocular hypertension was defined as intraocular pressures (IOP)>21 mm Hg (or an increase of>6 mm from baseline) with or without associated glaucomatous optic neuropathy after intake of steroids in any form...
April 2016: Journal of Glaucoma
Tamar Hajar, Yael A Leshem, Jon M Hanifin, Susan T Nedorost, Peter A Lio, Amy S Paller, Julie Block, Eric L Simpson
BACKGROUND: The National Eczema Association has received increasing numbers of patient inquiries regarding "steroid addiction syndrome," coinciding with the growing presence of social media dedicated to this topic. Although many of the side effects of topical corticosteroids (TCS) are addressed in guidelines, TCS addiction is not. OBJECTIVE: We sought to assess the current evidence regarding addiction/withdrawal. METHODS: We performed a systematic review of the current literature...
March 2015: Journal of the American Academy of Dermatology
Jane G Wigginton, Sarah M Perman, Gavin C Barr, Alyson J McGregor, Andrew C Miller, Anthony M Napoli, Anthony F Napoli, Basmah Safdar, Kevin R Weaver, Steven Deutsch, Tami Kayea, Lance Becker
Significant sex and gender differences in both physiology and psychology are readily acknowledged between men and women; however, data are lacking regarding differences in their responses to injury and treatment and in their ultimate recovery and survival. These variations remain particularly poorly defined within the field of cardiovascular resuscitation. A better understanding of the interaction between these important factors may soon allow us to dramatically improve outcomes in disease processes that currently carry a dismal prognosis, such as sudden cardiac arrest...
December 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Xin-Pu Miao, Jian-Sheng Li, Qin Ouyang, Ren-Wei Hu, Yan Zhang, Hui-Yan Li
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce inflammatory pain and swelling in inflammatory bowel disease (IBD) patients with rheumatological manifestations. While these drugs effectively reduce musculoskeletal pain and stiffness, long-term use is limited by gastrointestinal (GI) adverse effects (AEs) and disease exacerbation. As an alternative to NSAIDs, selective cyclooxygenase 2 (COX-2) inhibitors were developed to improve GI safety and tolerability...
2014: Cochrane Database of Systematic Reviews
Piera Versura, Giuseppe Giannaccare, Emilio C Campos
Dry eye (DE) is a multifactorial disorder of the ocular surface unit that results in eye discomfort, visual disturbance and ocular surface damage. It is one of the most common complaints in daily ophthalmic practice. The risk of DE increases with age in both sexes, while its incidence is higher among females. In addition, the condition of menopause in aging women may also contribute to DE onset or worsening as a consequence of an overall hormonal imbalance. Sex hormones play a key role in ocular surface physiology and they impact differently on ocular surface tissues...
February 2015: Current Eye Research
Nilesh Chande, Yongjun Wang, John K MacDonald, John W D McDonald
BACKGROUND: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. Corticosteroids and 5-aminosalicylates are the most commonly used therapies. However, many patients require immunosuppressive therapy for steroid-refractory and steroid-dependent disease. Methotrexate is a medication that is effective for treating a variety of inflammatory diseases, including Crohn's disease. This review was performed to determine the effectiveness of methotrexate treatment in UC patients. This review is an update of a previously published Cochrane review...
2014: Cochrane Database of Systematic Reviews
Irene van Echteld, Mihir D Wechalekar, Naomi Schlesinger, Rachelle Buchbinder, Daniel Aletaha
BACKGROUND: This is an update of a Cochrane review first published in 2006. Gout is one of the most common rheumatic diseases worldwide. Despite the use of colchicine as one of the first-line therapies for the treatment of acute gout, evidence for its benefits and harms is relatively limited. OBJECTIVES: To evaluate the benefits and harms of colchicine for the treatment of acute gout. SEARCH METHODS: We searched the following electronic databases from inception to April 2014: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE...
2014: Cochrane Database of Systematic Reviews
John W D McDonald, Yongjun Wang, David J Tsoulis, John K MacDonald, Brian G Feagan
BACKGROUND: Although corticosteroids are effective for induction of remission of Crohn's disease, many patients relapse when steroids are withdrawn or become steroid dependent. Furthermore, corticosteroids exhibit significant adverse effects. The success of methotrexate as a treatment for rheumatoid arthritis led to its evaluation in patients with refractory Crohn's disease. Methotrexate has been studied for induction of remission of refractory Crohn's disease and has become the principal alternative to azathioprine or 6-mercaptopurine therapy...
2014: Cochrane Database of Systematic Reviews
Morris Gordon, Kelly Taylor, Anthony K Akobeng, Adrian G Thomas
BACKGROUND: Crohn's disease (CD) is a chronic relapsing inflammatory condition. Many patients fail to achieve remission with medical management and require surgical interventions. Purine analogues have been used to maintain surgically-induced remission in CD, but the effectiveness of these agents is unclear. OBJECTIVES: The objectives were to evaluate the efficacy and safety of purine analogues for maintenance of surgically-induced remission in CD. SEARCH METHODS: We searched the following databases from inception to 30 April 2014: PubMed, MEDLINE, EMBASE, CENTRAL, and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register)...
2014: Cochrane Database of Systematic Reviews
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