By Thomas P. Habif MD, Thomas P. Habif
Thoroughly revised and up-to-date, the 4th version of this renowned reference provides a wealth of recent beneficial properties to permit readers to spot, deal with, and deal with epidermis illnesses extra simply than ever. Atlas-like assistance, complemented with distinctive, diagnostic textual content, mix to provide readers a uncomplicated source they'll seek advice many times. additionally on hand as a separate web site and e-dition package deal, this ebook is widely known because the world's best dermatologic manual.
* amazing photos of just about each universal dermis disorder.
* incorporates a crew of world-renown editors and contributors.
* makes use of a constant structure in each bankruptcy to provide info in a logical, easy-reference fashion.
* encompasses a unique part that includes dermatoscopy photographs and diagnostic thoughts for the analysis of cancer and different pigmented lesions.
* gains greater than 2 hundred new photographs in addition to new administration algorithms, making analysis and remedy even more efficient.
* Organizes illness details with an alphabetical directory at the inside of back and front covers, bearing in mind easy accessibility to precise guidance.
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Additional resources for Clinical Dermatology: A Color Guide to Diagnosis and Therapy
Example text
Patients must also be assured that if some atrophy does appear, it resolves in most cases when therapy is discontinued. MUCOSAL AREAS. Atrophy under the foreskin ( Figure 2-16 ) and in the rectal and vaginal areas may appear much more quickly than in other areas. [19] The thinner epidermis offers Figure 2-16 A, Steroid atrophy under the foreskin. Application of the group V topical steroid triamcinolone acetonide under the foreskin each day for 8 weeks produced severe atrophy and prominent telangiectasia of the shaft of the penis.
40 PATCH TESTING. Allergy to a component of the vehicle or the steroid molecule may occur. Patch testing for steroid cream allergy is complicated and usually performed by patch-test experts. Four groups of corticosteroids are recognized, where substances from the same group may cross-react. [23] The four groups are: group A (hydrocortisone type), group B (triamcinolone acetonides), group C (betamethasone type-nonesterified) and group D (hydrocortisone-17-butyrate type). The latter group is subclassified into two groups, group D1 (halogenated and with C16 substitution) and group D2 (the “labile” prodrug esters without the latter characteristics).
In an attempt to avoid complications, physicians often choose a weaker steroid preparation than that indicated; these weaker preparations all too frequently fall short of expectations and fail to give the desired antiinflammatory effect. The disease does not improve, but rather becomes worse because of the time wasted using the ineffective cream. Pruritus continues, infection may set in, and the patient becomes frustrated. 5% is a waste of time and money. Generally, a topical steroid of adequate strength (see Box 2-2 ) should be used 2 to 4 times daily for a specific length of time, such as 7 to 21 days, in order to obtain rapid control.