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Skin diseases & Corticosteroids

Skin diseases:

Adults & Pediatric Pediatric
Eczema
Urticaria
Drug Eruption
Angioedema
Erythema multiform
Psoriasis
Miliaria
Infantile Atopic dermatitis
Seborrhic dermatitis
Pityriasis Rosea
Diaper rash
Candida dermatitis
Irritant dermatitis

Skin tests:

Intradermal test Patch test Scratch test
Similar to a tuberculosis test.
During this test, a small amount of the allergen solution is injected into the skin.
An intradermal allergy test may be done when a substance does not cause a reaction in the skin prick test but is still suspected as an allergen for that person. The intradermal test is more sensitive than the skin prick test but is more often positive in people who do not have symptoms to that allergen (false-positive test results).
For a skin patch test, the allergen solution is placed on a pad that is taped to the skin for 24 to 72 hours.

This test is used to detect a skin allergy called contact dermatitis.




Also known as a puncture or prick test. 
This test is done by placing a drop of a solution containing a possible allergen on the skin, and a series of scratches or needle pricks allows the solution to enter the skin.
If the skin develops a red, raised itchy area (called a wheal), it usually means that the person is allergic to that allergen.
This is called a positive reaction.

Intradermal test


patch test Scratsh test

SCORAD index (Severity Scoring of Atopic Dermatitis)

A Extent criteria
B Intensity criteria
C Subjective symptoms
SCORAD index :  
A/5 + 7x B/2 + C =

Extent criteria:
The rule of 9  Grading in practice : It is advisable to draw lesion spread directly on the evaluation sheet and then perform the calculation.

Intensity criteria:

SCORAD index

Subjective symptoms:
 The two most representative items concerning the quality of life of patients are : Pruritus  and Insomnia

Corticosteroids

What is Cortisol?

Cortisol is a steroid hormone, in the glucocorticoid class of hormones, and is produced in humans by the zona fasciculata of the adrenal cortex within the adrenal gland. It is released in response to stress and low blood-glucose concentration

Pharmacological action:

Direct (Intended) Actions:

  • Anti-inflammatory
  • Anti-allergy
  • Anti-immunity

Permissive Actions

  • Lipolytic effects
  • Effect on blood pressure
  • Effect on bronchial muscles (e.g.,sympathomimetic amine)

Cortisol secretion:

The synthesis of cortisol in the adrenal gland is stimulated by the anterior lobe of the pituitary gland with adrenocorticotropic hormone (ACTH); ACTH production is in turn stimulated by corticotropin-releasing hormone (CRH), which is released by the hypothalamus.

Cortisol increase side effect:

Elevated cortisol level is found in many diseases, including infectious, aging-related, depression and depression -associated conditions; even in some with no known origin.

While it was initially thought that a high level is the result of these diseases, there is mounting evidence to the contrary, namely, that high cortisol actually plays a major role in inducing them, opening the possibility that anti cortisol drugs might represent a new beneficial therapy.

High levels for prolonged periods leads to fat deposition and often belly fat.

Hair analysis can reveal if seniors have elevated stress hormone levels that may put them at increased risk for heart disease and stroke.

Unlike a blood test that provides information about stress hormone levels at a single point in time, analysis of a strand of hair can reveal trends in levels of the stress hormone cortisol over several months, higher long-term levels are more likely to cause heart disease.

Addison Disease

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