tag:blogger.com,1999:blog-9870114.post1372890804595525767..comments2024-03-10T08:41:32.400+00:00Comments on VIRTUAL GRAND ROUNDS IN DERMATOLOGY 2.0: The Tortured TubeHumane Medicine Huihttp://www.blogger.com/profile/07113291188306363130noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-9870114.post-42262322267318626762016-09-29T00:50:08.833+00:002016-09-29T00:50:08.833+00:00Are you worried about rebound with such a short co...Are you worried about rebound with such a short course of prednisone?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9870114.post-1091527673658599552016-09-05T16:33:11.842+00:002016-09-05T16:33:11.842+00:00What kind of "health professional" is th...What kind of "health professional" is the patient's mother? <br /><br />She gave him "1% triamcinolone ointment"--where did she get this? It is supplied as 0.1%, not 1%. What was she treating?<br /><br />Whatever the dose, it is too strong to use around the eye and ointments act even stronger than creams since they are occlusive.<br /><br />Non-physicians often use an inappropriate strength of topical steroid and may not specify how long to use it.<br /><br />This is a big issue as more nurses and PAs work as physicians without a physician license and have little experience in skin diseases, but frequently use the highest strength of topical steroid in the erroneous notion that the strongest is the best for any skin disease. These are ideas I have gotten from some of these "prescribers" I have spoken to.<br /><br />I am not sure how these experiences will inform the new world of health care which is supposed to improve quality of care and efficiency.<br /><br />As for treatment, many of these patients will say that they cannot stop the strong steroid. I have them use 1% or 2.5% hydrocorticone cream in place of the stronger drug and will give them a few days of low-dose prednisone if not contraindicated along with encouragement that they are not addicted to the original cream. Cool compresses for a few minutes will help pruritis. The patient may need some hand-holding to get them through.<br />dermatologisthttps://www.blogger.com/profile/10665288748863571602noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-67630289171268725862016-09-05T09:53:11.432+00:002016-09-05T09:53:11.432+00:00Yoon Cohen wrote: "It is so tough to treat, a...Yoon Cohen wrote: "It is so tough to treat, and probably he will want to continue to apply even after learning the truth about potent steroid..<br />Would you consider Protopic or Elidel?"Humane Medicine Huihttps://www.blogger.com/profile/07113291188306363130noreply@blogger.com