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Topical steroid withdrawal, also known as red burning skin and steroid dermatitis, has been reported in people who apply topical steroids for 2 weeks or longer and then discontinue use. [ 4 ] [ 5 ] [ 2 ] [ 1 ] Symptoms affect the skin and include redness, a burning sensation, and itchiness, [ 2 ] which may then be followed by peeling.
Prednisone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive properties. [36] [37] Prednisone is a prodrug; it is metabolised in the liver by 11-β-HSD to prednisolone, the active drug. Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone. [38]
Recent research (Nixon & Vendelø, 2016) shows that General Practitioners (GPs) who actively consider discontinuation, are reluctant to do so, as they experience that the safest decision is to continue prescriptions, rather than discontinue them. In part this is due to the ambiguity about the appropriateness of discontinuing medication.
Prednisone treats these conditions because it stops the immune system from causing inflammation (or swelling). Although inflammation can be a necessary immune system function, too much ...
Prednisone: 3.5–5 0.8 16–36 Prednisolone: 4 0.8 ... ongoing exposure to the cause of the inflammation ... Stop entirely when dose is less than half of replacement ...
In pharmacologic (supraphysiologic) doses, glucocorticoids, such as prednisone, dexamethasone, and hydrocortisone are used to suppress various allergic, inflammatory, and autoimmune disorders. They are also administered as posttransplantory immunosuppressants to prevent the acute transplant rejection and graft-versus-host disease .
Treatment often involves the gradual weaning off the topical steroid, and the use of a systemic anti-inflammatory antibiotic. If the patient is using a strong topical steroid, he or she is weaned to a weaker class VI or VII steroid. Usually, they are to use the substitute steroid daily, then only on weekends, then stop completely.
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