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Rovner

SYSTEMIC DERMATOLOGIC THERAPY

  1. ANTIBIOTICS - Widespread, deep or potentially life threatening infection, (eg. folliculitis, cellulitis, ecthyma)
    1. Anti-Staphylococcal
      1. Erythromycin
      2. Beta-lactamase resistant Penicillins (Dicloxacillin, Augmentin)
      3. Cephalosporins (Keflex, Duricef)
      4. Penicillin and Tefracycline are NOT appropriate.
    2. Anti-Streptococcal
      1. Erythromycin
      2. Penicillins
    3. Acne
      1. Tetracyclines, Minocycline, Doxycyclene
      2. Erythromycins
      3. Amoxicillin
      4. Trimethoprim/sulfa (Bactrim)
      5. Clindamycin
      6. Cephalosporins (Duricef)
  2. ANTI-FUNGALS - Widespread or deep infections; nail infections
    1. Griseofulvin
      1. eg. Gris Peg, Fulvicin
      2. Dermatophyte infections only - no yeasts!
      3. Potentially hepatotoxic, phototoxic
    2. Imidazoles
      1. eg. Ketoconazole (Nizoral), Itraconazole (Sporanox)
      2. Drug interactions
      3. Potential hepatotoxicity
    3. Allyl Amines - (Lamisil)
  3. ANTI-HISTAMINES
    1. Sedating
      1. Hydroxyzine (Atarax)
      2. Diphenhidramine (Benadryl)
      3. Cyproheptadine (Periaction)
    2. Non-sedating
      1. Terfenadine (Seldane) Interaction with Macrolides
      2. Astemizole (Hismanal) and imidazoles
      3. Loratadine (Claritin)
    3. Mildly sedating
      1. Cetirizine (Zyrtec)
  4. STEROIDS - used to control acute flare of eczema, pemphigus,urticaria, and other inflammatory dermatoses except psoriasis
    1. Prednisone - usual dose is 0.5 to 1 mg/kg tapering over 3 to 4 weeks
    2. Other - equivalence:

    Decadron Triamicinolone, Prednisone Hydrocortisone Methyl Prednisdone Prednisolone

    0.75mg 4mg 5mg 20mg

    May be given PO, IM, IV, or intralesionally

     

  5. RETINOIDS - teratogenic
    1. Accutane (isotretinoin)
    2. Tegison (etretinate)
    3. Arotonoids