Several drugs commonly used in dermatology should be monitored regularly for (principally systemic) adverse effects. These include:
Aciclovir (plasma creatinine) Azathioprine (blood count and liver function) Colchicine (blood count, plasma creatinine) Ciclosporin (plasma creatinine) Dapsone (liver function, blood count including reticulocytes)
Methotrexate (blood count, liver function) PUVA (liver function, antinuclear antibodies) Aromatic retinoids (liver function, plasma lipids).
If it's wet, dry it; if it's dry, wet it. The traditional advice contains enough truth to be worth repeating. One or two applications a day are all that is usually necessary unless common sense dictates otherwise
Table 16.3 is not intended to give the complete treatment of even the commoner skin conditions but merely to indicate a reasonable approach.
Secondary infections of ordinarily uninfected lesions may require added topical or systemic antimicrobials.
Analgesics, sedatives or tranquillisers may be needed in painful or uncomfortable conditions, or where the disease is intensified by emotion or anxiety.
Formulations for use on the skin. At the time of writing there are in the UK about 280 preparations for medical prescription (excluding minor variants and many of those on direct sale to the public). It is not practicable to give other than general guidance on choice. Physicians will select a modest range of products and get to know these well.
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