A skin scraping and potassium hydroxide test can clarify whether a steroid or an antifungal is an appropriate choice. Topical corticosteroids are effective for conditions that are characterized by hyperproliferation, inflammation, and immunologic involvement. They can also provide symptomatic relief for burning and pruritic lesions. Many skin conditions are treated with topical steroids: dermatitis, psoriasis, lichen planus, DLE, poison ivy, nummular eczema, inflammatory dermatoses, pyoderma gangrenosum. They are available as solutions, lotions, creams, ointments, sprays, mousse, tapes. All have anti-inflammatory properties and vasoconstriction abilities.

• Weaker topical steroids – Used on thin-skinned and sensitive areas (eyelid, face, diaper area, perianal skin, groin, buttock cease, breast fold)• Moderate topical steroids – Moderately severe states (atopic dermatitis, nummular eczema, scabies)• Strong topical steroids – For severe states (psoriasis, lichen, DLE, sever poison ivy)

Classifications:

Class I – Very potent (600x more than hydrocortisone)• Clobetasol propionate (cream/ointment)• Halobetasol

Class III – Moderate (2-25x)• Clobetasol butyrate• Flumethasone pivalate• Triamcinolone acetonide

Class II – Potent (50-100x)• Betamethason valiate and gentamycin• Flucortolone acetonide• Methylprednisone

Class IV – Mild• Hydrocortisone and oxytetracylcine• Hydrocortison 17-butyrate