Id Reaction (Autoeczematization) Medication

  • Author: Matthew P Evans, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 11, 2012
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Corticosteroids

Class Summary

Help lesion resolution and provide symptomatic relief of pruritus. The strength and administration of a topical corticosteroid should be chosen based upon the extent, location, and morphology of the eruption. Systemic corticosteroids may be used for severe or refractory eruptions.

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Amcinonide (Cyclocort)

 

Suppresses mitotic activity and causes vasoconstriction. Stimulates synthesis of enzymes needed to decrease inflammation.

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Fluocinonide (Fluonex, Lidex)

 

High-potency steroid that inhibits cell proliferation. Is immunosuppressive, antiproliferative, and anti-inflammatory. Also has antipruritic and vasoconstrictive properties.

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Prednisone (Orasone, Sterapred, Deltasone)

 

Commonly used oral agent. Indicated for severe, prolonged, or anaphylactic reactions. Decrease late immune-mediated complications. Must be metabolized to the active metabolite prednisolone for effect. Conversion may be impaired in liver disease.

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Methylprednisolone (Depo-Medrol, Medrol, Adlone, Solu-Medrol)

 

May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Indicated for severe, prolonged, or anaphylactic reactions. Decrease late immune-mediated complications.

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Antihistamines

Class Summary

These agents relieve pruritus. May control itching by blocking effects of endogenously released histamine.

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Diphenhydramine (Benadryl, Benylin, Caladryl, Dermapax)

 

First-generation antihistamine with anticholinergic effects that binds to H1 receptors in the CNS and the body.

Competitively blocks histamine from binding to H1 receptors. Has significant antimuscarinic activity and penetrates CNS, which causes pronounced tendency to induce sedation. Approximately half of those treated with conventional doses experience some degree of somnolence. A small percentage of children paradoxically respond to diphenhydramine with agitation.

For symptomatic relief of symptoms caused by release of histamine in allergic reactions.

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Loratadine (Claritin, Alavert)

 

Selectively inhibits peripheral histamine H1 receptors. Tolerated well, with rate of sedation not significantly different from placebo.

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Contributor Information and Disclosures
Author

Matthew P Evans, MD  Dermatology, Dreyer Medical Group

Matthew P Evans, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Darryl Bronson, MD, MPH  Consultant and Immediate Past Chairman, Division of Dermatology, Department of Medicine, Cook County Hospital of Chicago; Instructor, Department of Dermatology, University of Illinois at Chicago

Darryl Bronson, MD, MPH, is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Illinois State Medical Society, Noah Worcester Dermatological Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Donald Belsito, MD  Professor of Clinical Dermatology, Department of Dermatology, Columbia University Medical Center

Donald Belsito, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Dermatology Foundation, New York County Medical Society, New York Dermatological Society, Noah Worcester Dermatological Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD  Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology

Disclosure: Amgen Honoraria Consulting; Celgene Honoraria Safety Monitoring Committee

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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