CORTISONE AND THE SKIN
Before using a corticosteroid preparation, two important factors must be considered. The first and foremost is the diagnosis. It is most important that the diagnosis be correct, as while cortisone may suit one skin condition, it may have an adverse reaction on some very similar condition. Any confusion in this regard could have drastic consequences. The conditions most responsive to topical corticosteroids are: atopic eczema—flexural, discoid, dyshydrotic; contact dermatitis—allergic, irritant; neurodermatitis; varicose eczema; seborrhoeic eczema; psoriasis.
Adverse reactions to the use of topical corticosteroid are seen in the following conditions:
acne—adolescent, rosacea; infections—bacterial, viral, fungal, parasitic; leg ulcers.
The second factor to consider is which preparation to use. Obviously the best principle is to use hydrocortisone (the mildest steroid) where possible, or a stronger fluorinated compound in its lowest effective concentration; the chosen preparation should be applied to the smallest possible area for the shortest period of time.
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