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Id Reaction (Autoeczematization) Medication

  • Author: Matthew P Evans, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Oct 14, 2015
 

Medication Summary

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

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Corticosteroids

Class Summary

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

Amcinonide (Cyclocort)

 

Amcinonide suppresses mitotic activity and causes vasoconstriction. It stimulates the synthesis of enzymes needed to decrease inflammation.

Fluocinonide (Fluonex, Lidex)

 

Fluocinonide is a high-potency steroid that inhibits cell proliferation. It is immunosuppressive, antiproliferative, and anti-inflammatory. It also has antipruritic and vasoconstrictive properties.

Prednisone (Orasone, Sterapred, Deltasone)

 

Prednisone is a commonly used oral agent. It is indicated for severe, prolonged, or anaphylactic reactions. It decreases late immune-mediated complications. Prednisone must be metabolized to the active metabolite prednisolone for effect. Conversion may be impaired in liver disease.

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

 

Methylprednisolone may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. It is indicated for severe, prolonged, or anaphylactic reactions. It decreases late immune-mediated complications.

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Antihistamines

Class Summary

These agents relieve pruritus. They may control itching by the blocking effects of endogenously released histamine.

Diphenhydramine (Benadryl, Benylin, Caladryl, Dermapax)

 

Diphenhydramine is a first-generation antihistamine with anticholinergic effects that binds to H1 receptors in the CNS and the body.

It competitively blocks histamine from binding to H1 receptors. It has significant antimuscarinic activity and penetrates the CNS, which causes a 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.

It is for symptomatic relief of symptoms caused by the release of histamine in allergic reactions.

Loratadine (Claritin, Alavert)

 

Loratadine selectively inhibits peripheral histamine H1 receptors. It is tolerated well, with a rate of sedation not significantly different from placebo.

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Contributor Information and Disclosures
Author

Matthew P Evans, MD Chair, Department of Dermatology, Dreyer Medical Clinic

Matthew P Evans, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Chicago Dermatological Society

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, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

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, American College of Rheumatology

Disclosure: Received income in an amount equal to or greater than $250 from: XOMA; Biogen/IDEC; Novartis; Janssen Biotech, Abbvie, CSL pharma<br/>Received honoraria from UpToDate for author/editor; Received honoraria from JAMA Dermatology for associate editor and intermittent author; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for i inherited these trust accounts; for: Celgene; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble; Amgen.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

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: New York County Medical Society, Noah Worcester Dermatological Society, Phi Beta Kappa, American Contact Dermatitis Society, Dermatology Foundation, Dermatologic Society of Greater New York, Alpha Omega Alpha, American Academy of Dermatology

Disclosure: Nothing to disclose.

References
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