DERMATITIS &

ECZEMA
Pharmacology II
Self-Directed Learning
Dermatitis
◦ Dermatitis refers to a group of inflammatory conditions. It affects
the outer layer of the skin, the epidermis.
◦ Though the disorder can have many causes and occur in many
forms, it usually involves swollen, reddened and itchy skin
◦ Dermatitis is not life-threatening or contagious
Dermatitis
◦ Common signs and symptoms include:
◦ Redness
◦ Swelling
◦ Itching
◦ Skin lesions
Different Types of Dermatitis
Seborrheic
Dermatitis
Contact Atopic
Dermatitis Dermatitis

Stasis
Dermatitis

Stasis dermatitis is caused by fluid

accumulation under the skin of the
legs due to poor circulation
Contact Dermatitis
◦ Dermatitis that results from direct contact with one of many
irritants or allergens.
◦ Common irritants include
◦ Laundry soap, skin soaps or detergents, and cleaning products.
◦ Irritant- shorter time to develop dermatitis
◦ Allergen-longer time to develop dermatitis
◦ Initial exposure – Sensitize immune system
◦ consequent brief exposure to a small amount
of it can cause dermatitis.
◦ Allergen sensitivities is for life.
Seborrheic Dermatitis
◦ Red rash with yellowish and "oily" scales, usually on the scalp
◦ Accelerated cell turnover
◦ Malassezia organisms indirectly cause it
◦ In adult
◦ during times of physical stress, travel or in people who have
neurological conditions, such as Parkinson's disease
◦ In infants
◦ cradle cap
Atopic Dermatitis
◦ A.k.a Eczema
◦ A type of dermatitis that often runs in families and is associated
in patients who have asthma or allergies.
◦ Unknown cause
◦ Likely due to a combination of
◦ dry, irritable skin together with a malfunction in the body's immune
system
◦ Stress can exacerbate atopic dermatitis
TREATMENT
Contact Dermatitis
◦ Identifying the cause
◦ avoiding the irritant or allergen
◦ Topical corticosteroids
◦ help relieve inflammation and itching
◦ Antihistamines
◦ To relieve the itching
◦ Antibiotic, antiviral, or antifungal medicines
◦ If it has other infection
◦ Duration
◦ two to four weeks for to clear up
Contact Dermatitis
◦ Topical corticosteroids
◦ Example:
◦ Hydrocortisone: 1%, 0.5%
◦ Betamethasone: 0.25%, 0.5%, 0.1%
◦ Clobetasol :0.05%
◦ In different dosage form and strength
◦ Lotion, cream and ointment
◦ MOA
◦ Suppress various components of the inflammatory reaction
◦ Modify body's immune response to diverse stimuli.
 Topical Steroid Potency
Potency Topical corticosteroid Brand/ Combination creams
Hydrocort cream/ Fucidin-H/
Hydrocortisone 1%
Mild Daktacort
Desonide 0.05% Desowen Lotion
Moderate Betamethasone valerate
¼ Bet cream
(2-25 times 0.025%
hydrocortison Flucinolone acetonide
e potency) 0.00625%
Mometasone Furoate
Elomet cream
0.1% cream
Bethametasone valerate
Potent F/S Bet Cream, Fucicort,
0.1% cream
(100-150 times
Beprosone/ Combiderm/
hydrocortison Betamethasone
diprogenta/ gentrisone/ Neoderm/
e potency) diproprionate 0.05%
Triderm/ Fobancort
Fluticasone proprionate
Cutivate Cream
0.05%
Clobestasol Proprionate
Dermovate/ Cloderm
0.05%
Very Potent
Betamethasone
(600 times
diproprionate 0.05% in Diprocel
hydrocortison
optimized vehicle
e potency)
Diflucortolone valerate
Travacort
0.3%
Contact Dermatitis
◦ Topical corticosteroid
◦ Adverse Effect
◦ Rare side effect with mild and moderate group
◦ Thinning and drying of skin
◦ Acne at side of application
◦ Mild pigmentation (reversible)
◦ Potent topical steroid may cause serious systemic side effects such as :-
◦ Cushing syndrome
◦ Pituitary adrenal axis suppression
Contact Dermatitis
◦ Topical corticosteroid
◦ Precaution/Warning
◦ When treatment with topical corticosteroids begins. Prescribe medicines in a
pulse pattern
◦ use corticosteroids for 2 weeks. Stop using them for 2 weeks. Then apply
corticosteroids for another 2 weeks
◦ No prolong usage
◦ Use moisturiser to keep skin hydrated (as topical steroid can cause dry skin)
Contact Dermatitis
◦ Antihistamines
◦ Example:
◦ Sedating: Chlorpheniramine, Hydroxyzine
◦ Non-sedating: Loratadine, Cetirizine
◦ MOA
◦ Blocking the histamine processes in an allergic reaction
◦ Side Effect
◦ Drowsiness
◦ Weakness
◦ Blurred vision
◦ Upset stomach
◦ Dry nose, mouth, & throat
◦ Precaution
◦ In those who have bladder/eye condition
◦ Children and elderly more prone to side effect
Seborrheic Dermatitis
◦ Medicated shampoos are usually the first treatment choice
◦ contain tar,
◦ zinc,
◦ salicylic acid or
◦ ketoconazole
◦ Hydrocortisone (steroid) creams and lotions may soothe nonscalp
seborrheic dermatitis
Seborrheic Dermatitis
◦ Medicated Shampoo
◦ Salicylic acid
◦ Tar
◦ Selenium
◦ Zinc
◦ MOA
◦ Soften thick scalp plague
◦ Precaution
◦ Do not use everyday, use in alternate day with normal shampoo
Seborrheic Dermatitis
◦ Antifungal Shampoo
◦ Example:
◦ Ketoconazole 2%
◦ MOA:
◦ Inhibit biosynthesis of ergosterol – damage fungal cell wall
◦ Inhibit enzyme causing intracellular accumulation of peroxide - toxic to
fungal cells.
◦ Usage:
◦ Shampoo: After lathering, let soak in for 10 min prior to rinsing
◦ Max is 3 times a weeks
Atopic Dermatitis
◦ Topical corticosteroids
◦ Antihistamines
◦ Antibiotic, antiviral, or antifungal medicines
◦ Topical calcineurin inhibitors
◦ Oral corticosteroids
◦ Cyclosporine
Atopic Dermatitis
 Calcineurin inhibitors (topical immunosuppressants)
 Example:
 Pimecrolimus
 Tacrolimus
 MOA
 Suppress body's immune system.
 AE: Transient burning, erythema, and pruritus
 Precaution
 Caution when prescribing and using because of a potential cancer risk
 Only be used as directed
 Second line therapy
 Approved for children older than 2 years of age.
Atopic Dermatitis
◦ Cyclosporine
◦ Immunosuppressant
◦ MOA
◦ Suppress the immune system
◦ Precaution
◦ Increased blood pressure and kidney problems
◦ Blood pressure and kidney function are monitored every 2 to 4 weeks during
treatment
◦ Avoid sun exposure
◦ Increase chance of skin cancer
THANK YOU !