practical notes on clincal dermatology2

The side effects of prolonged used of systemic

Corticosteroids
-Lowering the resistance to many infections.
-Metabolic disturbance, particularly in regard to electrolytes and carbohydrates leading to fluid retention with particular type of edema (moon face).
-Increase body weight.
-Increase in diastolic blood pressure.
-Osteoporosis.
-Hirsutism.
Striae.
Acne.
-Emotional disturbance.
-Aggravate diabetes and precipitate it in susceptible individuals.
-It should not be give to patients with duodenal ulcers and pulmonary tuberculosis.
Griseofulvin
It is an antifungal antibiotic .It has a fungicidal property, inhibiting the fungal mitosis so that infection is carried away by the out growth of keratin .The infected layers in the skin takes about 10 –14 days to be shed .In the palms and soles it takes 4 – 6 weeks .So the drug should be given for this period it is effective in all superficial fungal infection (Dermatophytes
+) except tinea versicolor and Candidiasis.
It is contraindicated in:
1- Pregnancy.
2- Sever liver disease.
3- SLE.
4- Porphyria.
Dose: The pediatric dosage is 10g /kg. B. Wt. once daily .For adult 500 mg/day and up to 1000 mg daily for sever and refractory conditions.

Nystatin (mycostatin)
Is a related to polyen antifungals that act by forming channels in the membrane of the fungus and increasing permeability.
It is effective against Candidal infection (yeast – organisms), but has no effect on bacteria and Dermatophyte infection (filamentous fungi) .It is poorly absorbed from the gastro –intestinal tract .So in cutaneous moniliasis, it is effective only by topical application.
The benefits of using Methotrexate in psoriasis
Psoriatic skin has more cells in replication at any one time than normal skin, Methotrexate (MTX) by it’s inhibitory effect on DNA synthesis, apparently function as a direct suppres