Intralesional steroid injections for psoriasis

MATERIALS AND METHODS: A retrospective chart review of 284 consecutive referrals for phimosis to the Children's Hospital of Eastern Ontario (CHEO) Urology Clinic during November 2000 - April 2003 was conducted. Referral sources included family physicians (FP), pediatricians (PD), emergency physicians (ER), and other subspecialists (SS). Data for this study were obtained from the original referral letters and cross-referenced with the impressions of the pediatric urologist following the initial patient encounter. The accuracy in diagnosing phimosis was evaluated among the various types of referring physicians.

The adverse effects of corticosteroids in pediatric patients are similar to those in adults (see ADVERSE REACTIONS ). Like adults, pediatric patients should be carefully observed with frequent measurements of blood pressure, weight, height, intraocular pressure, and clinical evaluation for the presence of infection, psychosocial disturbances, thromboembolism , peptic ulcers, cataracts, and osteoporosis. Pediatric patients who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity. This negative impact of corticosteroids on growth has been observed at low systemic doses and in the absence of laboratory evidence of HPA axis suppression (ie, cosyntropin stimulation and basal cortisol plasma levels). Growth velocity may therefore be a more sensitive indicator of systemic corticosteroid exposure in pediatric patients than some commonly used tests of HPA axis function. The linear growth of pediatric patients treated with corticosteroids should be monitored, and the potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the availability of treatment alternatives. In order to minimize the potential growth effects of corticosteroids, pediatric patients should be titrated to the lowest effective dose.

Pregnancy Category C. Corticosteroids have been shown to be teratogenic in many species when given in doses equivalent to the human dose. Animal studies in which corticosteroids have been given to pregnant mice, rats, and rabbits have yielded an increased incidence of cleft palate in the offspring. There are no adequate and well-controlled studies in pregnant women. Corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Infants born to mothers who have received corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.

Treatment is difficult. Due to the intensity of the itch patients often go from doctor to doctor looking for relief. No one treatment is always effective and several treatments may need to be tried. Initial treatment is often potent prescription steroid creams . If these help, a milder cream can be used for longer-term control. Antihistamine creams (Zonalon, Pramoxine) or pills (Atarax, Periactin) are often added for additional relief. Intralesional steroid injections , anti-depressant pills, and non-prescription capsaicin cream helps many of those not improved with the usual treatment.

Intralesional steroid injections for psoriasis

intralesional steroid injections for psoriasis

Treatment is difficult. Due to the intensity of the itch patients often go from doctor to doctor looking for relief. No one treatment is always effective and several treatments may need to be tried. Initial treatment is often potent prescription steroid creams . If these help, a milder cream can be used for longer-term control. Antihistamine creams (Zonalon, Pramoxine) or pills (Atarax, Periactin) are often added for additional relief. Intralesional steroid injections , anti-depressant pills, and non-prescription capsaicin cream helps many of those not improved with the usual treatment.

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