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Whether or not to use systemic corticosteroids to treat a skin disease - This Changed My Practice

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  How long does prednisone stay in your system? Take an oral dose by mouth with or without food as directed by your doctor. Take the dose of. 1. You may not notice benefits right away. For most people, prednisone starts working. This can happen if you take this drug for a long time or if you suddenly stop taking this drug. Do not stop taking prednisone without talking to your doctor. ❿  


How long does it take for prednisone to work for rash.How Long Does it Take Prednisone to Work?



  Nicotinamide and tetracycline therapy of bullous pemphigoid. Your doctor will determine the best dosage for your child.     ❾-50%}

 

How long does it take for prednisone to work for rash.What Is the Most Effective Skin Rash Treatment?



    For people living with eye problems: Long-term prednisone use can increase your risk of getting eye infections, cataracts, or glaucoma. Simon Moore Dr.

Treating with topical corticosteroid is sometimes as effective for skin disease as the systemic drug:. There is evidence to show that treating severe bullous diseases with potent topical corticosteroids can be as effective as treating with systemic.

Topical treatment is very much safer as very little of the drug is absorbed even with open lesions. Also, as the skin heals even less corticosteroid is absorbed.

Bullous pemphigoid most common in elderly patients is now often treated with topical corticosteroids alone or in combination with high doses of tetracycline and niacinamide 6,7. Patients who may require systemic corticosteroids include patients with severe or unresponsive disease or those intolerant to other treatment.

Diseases most frequently treated include drug reactions, AD, nummular dermatitis, ACD, bullous pemphigoid and lichen planus. From: Murray Eileen, Diagnosing Skin Diseases: A diagnostic tool and educational resource for pediatricians and primary care givers. Note: Wet dressings are cool and soothing, antipruritic, and antiseptic. They also enhance absorption of topical medications. They are the epitome of a treatment that always helps and never harms.

For skin diseases with weeping or crusting a wet dressing open to the air dries the lesions. If the skin is dry an occluded wet dressing increases moisture retention. Physicians began using wet dressings several hundred years ago. Solutions were compounded by surgeons treating wounded soldiers. Many lives were saved because the wet dressings greatly reduced the risk of infection. Karl August Burow, -a German surgeon, an inventor of both plastic surgery and wound healing techniques.

Whether or not to use systemic corticosteroids to treat a skin disease. View Results. Read More 2 Comments. The information presented here is interesting, but anecdotal.

If I am to weigh the risk and benefit of offering oral steroids to my patients I need to get a sense of how likely such adverse events are. I agree with Dr. Murray that it is important to know that this complication happens in the 50mg per day dosing range, and I thank her for her contribution — but a decision to abandon a traditional and highly effective treatment requires a better sense of absolute risk.

The orthopaedic surgeon who put together the osteonecrosis case series discussed in this article sees a highly select population of those who suffer such complications. What was the denominator? Having written perhaps prescriptions for oral steroids I have never seen this complication — although clearly that is too small a sample size to be meaningful. The next time your local Division of Family Practice gets together count heads, and years of practice, and ask how many cases of osteonecrosis secondary to oral steroids the group has seen.

I thank Dr. Scott Garrison for his thoughtful comments. Statistics are not my thing so am not able to provide a sense of absolute risk. I do think that the large cohort study by Dr. Feng-Chen Kao provides compelling evidence for the association of systemic corticosteroid use with both fracture-related arthroplasty and fracture-unrelated surgery. In a group of 21, users matched with non-users followed over 12 years, the hazard ratio HR was double for steroid users over non-users.

The HR increased with increased steroid dosage, particularly in those with fracture-unrelated arthropathy. The adjusted HR increased from 3. I think the most important point is that systemic corticosteroids are not a substitute for topical corticosteroids. They are a potent, broad-spectrum immunosuppressive agent and need to be prescribed with the same cautions you would use with any other immunosuppressive agent. Topical corticosteroids are potent immunosuppressants but with normal use, rarely cause systemic symptoms.

Our skin is an excellent barrier. I remember seeing a sixteen-year-old girl who had been prescribed clobetasol cream to treat her atopic dermatitis. It cleared her disease. However, she continued to apply it to her skin every morning after her shower to prevent the eczema from coming back. She continued the daily treatment for a year. By that time, she had developed severe striae over her arms and legs. She was assessed by an endocrinologist and had no evidence of adrenal suppression.

Notify me of followup comments via e-mail. You can also subscribe without commenting. Whether or not to use systemic corticosteroids to treat a skin disease By Dr.

Eileen Murray on October 3, Dr. What I did before When I started out in dermatology, corticosteroids were the only systemic drug available to treat patients with severe allergic contact dermatitis ACD , atopic dermatitis AD , drug reactions and those with bullous diseases. What changed my practice The following article made me change the way I treated ACD and stimulated me to try to avoid using systemic corticosteroids when at all possible. What I do now 1. Allergic contact dermatitis: Each patient with ACD is instructed to apply a wet dressing 3,4 see Patient handout three times daily for 15 to 20minutes followed by the application of clobetasol propionate cream — the most potent topical corticosteroid.

Oral corticosteroids will clear psoriasis. However, when the drug is discontinued the disease recurs, is much worse and much more resistant to other treatments. Chronic urticaria defined as daily or almost daily hives for longer than six weeks , is one of the most difficult diseases to manage.

In most cases it is impossible to determine the cause. Therefore, it is important to treat with drugs that are safe to use long-term. Do not treat undiagnosed skin disease or itching with systemic corticosteroids: Case 1 A young man in the middle of the night presented to the emergency with a generalized rash and severe itching; so severe he was begging for relief. Case 2 An older male patient, within hours of inadvertently ingesting one cloxacillin capsule, presented with fever, facial swelling, diffuse erythema and numerous pin-sized non-follicular pustules.

Treating with topical corticosteroid is sometimes as effective for skin disease as the systemic drug: There is evidence to show that treating severe bullous diseases with potent topical corticosteroids can be as effective as treating with systemic.

If you feel that you might need to treat with systemic corticosteroids: Have an unequivocal diagnosis. Biopsy a lesion if you are not sure If possible, eliminate the cause drug or herb, allergen Treat with a super potent topical corticosteroid before considering systemic treatment.

Rule out chronic infectious disease Treat confounding factors dry skin. Consider other options, including the topical immunosuppressive drug — tacrolimus. Consider other immunosuppressive agents — oral retinoids, methotrexate or biologics. Have a detailed treatment plan. Treat for the shortest possible time. Institute osteoporosis prevention for longer treatment courses. The solution should be cool, tepid or warm but not hot or cold.

OR Dissolve 1 tsp of salt in 2 cups of water. OR Mix equal parts milk and water infrequently used and most often for facial rashes. Wet a soft cotton cloth with the solution an old sheet or diaper or cotton t-shirt cut to fit the affected area and wring out the cloth so that it is wet but not dripping.

Keep the cloth wet for the entire application time by taking it off and rewetting it or by pouring some of the solution directly onto it. Remove the wet cloth and apply the medication prescribed to the damp skin.

It was terrible! I gotta be their mommy. So I took my first dose of prednisone that night, right after I got diagnosed with ITP , my bleeding disorder. Then they checked my blood the next morning. Then they checked it the next night , the following morning , and the next morning. I was thrilled! I can help my kids get their Halloween costumes on and be home to Trick-or-Treat.

So for me, just that one huge first dose was enough to make the prednisone start to work. Prednisone worked after just one dose for me. My story showed that 1 the diagnosis of ITP responded quickly, and 2 the dose was high enough to work quickly. We will go into these two vital factors in more depth next.

Every person has a unique diagnosis, condition, or disease that requires a different level of treatment. Topical steroids that are commonly prescribed include fluocinonide, hydrocortisone, and clobetasol.

Oral steroids, such as prednisone, also work by suppressing the immune system, thereby alleviating the swelling, itching, and redness. Your dermatologist may prescribe oral steroids in conjunction with antihistamines, such as loratadine or diphenhydramine, to effectively treat mild to moderate itching.

If your rash has cracked and comes with pain, swelling, warmth in the area, and purulent fluid, your dermatologist may prescribe oral or topical antibiotics. Oral antibiotics are also recommended for cases of perioral dermatitis, a condition characterized by a red rash around the mouth.

Your dermatologist may recommend self-care measures, such as the following, to directly address your rashes or enhance the results of the treatment options mentioned above. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you are aged 65 years and older, you may need a lower dose or a different dosing schedule.

For immediate-release tablets only: If you have a sudden return or worsening of your MS symptoms, you may need to take mg once per day for one week. This dosage may then be reduced to 80 mg once per day every other day for one month. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. Always speak with your doctor or pharmacist about dosages that are right for you.

For this drug to work well, a certain amount needs to be in your body at all times. If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:. But if your symptoms are severe, call or go to the nearest emergency room right away. What to do if you miss a dose: If you forget to take a dose, take it as soon as you remember.

How to tell if the drug is working: You should experience less pain and swelling. There are also other signs that show that prednisone is effective, depending on the condition being treated. Talk with your doctor if you have questions about whether this medication is working.

Your doctor may do tests to check your health and make sure the drug is working and is safe for you. These tests may include:. Steroids such as prednisone change the amount of water and salts in your body. In large doses, prednisone can cause your body to retain salt or lose potassium. Your doctor may recommend changes to your diet to manage this side effect. There are other drugs available to treat your condition. Some may be better suited for you than others.

Talk with your doctor about other drug options that may work for you. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication.

The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Methylprednisolone and prednisone are medications that can treat certain health conditions, such as rheumatoid arthritis, by reducing inflammation in….

Prednisone is a steroid that can be used as part of a person's treatment after they have a significant asthma attack. In this article, we examine the….

Prednisone is a prescription steroid drug. It comes as an immediate-release tablet, a delayed-release tablet, and a liquid solution. You take all of these forms by mouth. Prednisone delayed-release tablet is available as a generic drug and as the brand-name drug Rayos. The immediate-release tablet is only available as a generic drug.

Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug. Prednisone works by weakening your immune system. If these effects are mild, they may go away within a few days or a couple of weeks. Call your doctor right away if you have serious side effects. Serious side effects and their symptoms can include the following:.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history. Prednisone oral tablet can interact with other medications, vitaminsor herbs you may be taking.

An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. To help avoid interactions, your doctor should manage all of your medications carefully. Taking mifepristone with prednisone may prevent prednisone from working correctly.

Taking bupropion with prednisone may cause seizures. Taking prednisone weakens your immune system. If you receive a live vaccine while taking prednisone, your immune system might not be able to handle it properly. This may lead to an infection. Taking prednisone with drugs that treat diabetes may result in an increase in your blood glucose levels and problems controlling your diabetes. Examples of these drugs include:. Taking warfarin with prednisone may reduce the blood-thinning effect of warfarin.

If you take these drugs together, your doctor may monitor your treatment with warfarin closely. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions.

Prednisone oral tablet can cause a serious allergic reaction in some people. This reaction can cause a skin rash, which can include:. Taking it again could be fatal cause death. For people with infections: Taking prednisone weakens your immune system and can worsen an infection you already have. It also increases your risk of getting a new infection.

For people living with heart or kidney disease: Prednisone may make you retain salt and water, which can raise your blood pressure. For people living with diabetes: Prednisone can increase your blood sugar level. You might need to monitor your blood sugar level more closely. If it goes up too much, your dosage of diabetes medication might need to be changed. For people living with eye problems: Long-term prednisone use can increase your risk of getting eye infections, cataracts, or glaucoma.

Let your doctor know if you experience any vision changes or eye pain. For people living with stomach problems: Prednisone can cause damage to your stomach.

Let your doctor know if you experience bad stomach pain that does not go away or you get dark or bloody stools. For people living with mood disorders: Prednisone may cause changes in your mood or behavior. Let your doctor know if you have changes in your mood, feel depressed, or have trouble sleeping. Research in animals has shown adverse effects on the fetus when the mother takes prednisone. Studies show a risk of adverse effects to the pregnancy when the mother takes the drug.

Prednisone can be passed through breast milk. For older people: As you age, your kidneys, liver, and heart may not work as well.

Prednisone is processed in your liver and removed from your body through your kidneys. It makes these organs work extra hard. For children: Children might not grow as tall if they take prednisone for several months. This dosage information is for prednisone oral tablet. All possible dosages and forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:. Dosage for children is usually based on weight. Your doctor will determine the best dosage for your child.

Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you are aged 65 years and older, you may need a lower dose or a different dosing schedule. For immediate-release tablets only: If you have a sudden return or worsening of your MS symptoms, you may need to take mg once per day for one week. This dosage may then be reduced to 80 mg once per day every other day for one month.

However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. Always speak with your doctor or pharmacist about dosages that are right for you.

For this drug to work well, a certain amount needs to be in your body at all times. If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:. But if your symptoms are severe, call or go to the nearest emergency room right away. What to do if you miss a dose: If you forget to take a dose, take it as soon as you remember. How to tell if the drug is working: You should experience less pain and swelling.

There are also other signs that show that prednisone is effective, depending on the condition being treated. Talk with your doctor if you have questions about whether this medication is working. Your doctor may do tests to check your health and make sure the drug is working and is safe for you.

These tests may include:. Steroids such as prednisone change the amount of water and salts in your body. In large doses, prednisone can cause your body to retain salt or lose potassium. Your doctor may recommend changes to your diet to manage this side effect. There are other drugs available to treat your condition. Some may be better suited for you than others.

Talk with your doctor about other drug options that may work for you. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication.

The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Methylprednisolone and prednisone are medications that can treat certain health conditions, such as rheumatoid arthritis, by reducing inflammation in…. Prednisone is a steroid that can be used as part of a person's treatment after they have a significant asthma attack.

In this article, we examine the…. New research in mice suggests that a weekly dose of the common corticosteroid prednisone may help weight loss. Prednisone can cause insomnia as a side effect, but there are some changes people can make to minimize this symptom.

Learn more here. Methylprednisolone oral tablet is a prescription drug used for many conditions involving the immune system. Learn the mild and serious side effects it…. How to understand chronic pain What is behind vaccine hesitancy? The amazing story of hepatitis C, from discovery to cure New directions in dementia research Can psychedelics rewire a depressed, anxious brain?

Medical News Today. Health Conditions Discover Tools Connect. Prednisone, oral tablet. Medically reviewed by Alan Carter, Pharm. Important warnings.

localhost › GoodRx Health › Drugs › Prednisone. Prednisone usually works very quickly, within a few hours to days of taking the first dose depending on the condition you are treating. Prednisone can work within hours after just one dose, depending on (1) what you're taking it for, and (2) how high of a dose your doctor prescribed. It's an. I've tried just about every over the counter cream and ointments recommended by doctors. The PA I work with suggested prednisone for a weeks time. Two 20mg for. Doctors often prescribe an oral corticosteroid, like prednisone, along with an antihistamine to treat mild itchy rashes. Megan Milne, the Prednisone Pharmacist. The main problem with systemic use is the high risk of drug interactions, as well as multiple serious acute and long-term side effects. In a similar way, for rheumatic conditions, prednisone will work quickly to ease the pain.

By Dr. Eileen Murray on October 3, Eileen Murray MD FRCPC biography and disclosures Disclosures: Served as a consultant for the pharmaceutical industry and participated in clinical research evaluating new therapies for psoriasis and atopic dermatitis. When I started out in dermatology, corticosteroids were the only systemic drug available to treat patients with severe allergic contact dermatitis ACD , atopic dermatitis AD , drug reactions and those with bullous diseases. Corticosteroids are potent and excellent immunosuppressive agents.

The main problem with systemic use is the high risk of drug interactions, as well as multiple serious acute and long-term side effects. It was the belief at the time that patients treated oral corticosteroids for short periods, two weeks or less for instance were not adversely affected by treatment. Severe ACD caused by poison ivy was the disease I treated most frequently with systemic corticosteroids.

Patients were given a two-week course of oral Prednisone, 50mg daily for seven days and 25mg daily for another seven total dose of mg. Two weeks of treatment was necessary to prevent recrudescence and completely clear the eruption.

The following article made me change the way I treated ACD and stimulated me to try to avoid using systemic corticosteroids when at all possible. McKee et al 1 reported a group of male patients who had developed osteonecrosis six to thirty-three months after a single short-course of oral corticosteroids within three years of presentation.

The mean steroid dose in equivalent milligrams of prednisone was range — mg. The mean duration of drug therapy was Osteonecrosis is a known complication of systemic corticosteroid use and was initially believed to occur only in patients who received high doses equivalent to more than mg of prednisone for extended periods 3 months or longer.

Each patient with ACD is instructed to apply a wet dressing 3,4 see Patient handout three times daily for 15 to 20minutes followed by the application of clobetasol propionate cream — the most potent topical corticosteroid. The patient continues the wet dressings daily until they are no longer itchy. Soon after changing my practice, I had a series of patients with severe, generalized ACD appearing two days post surgery.

Systemic treatment would have interfered with post operative healing. All of them were treated with the topical regime and had quick relief of itching.

Their ACD cleared just as quickly as those patients I had previously treated with systemic corticosteroids. Psoriasis and chronic urticaria: do not treat either of these diseases with systemic corticosteroids!

Do not treat undiagnosed skin disease or itching with systemic corticosteroids:. A young man in the middle of the night presented to the emergency with a generalized rash and severe itching; so severe he was begging for relief. Three weeks previously he had been seen in a walk-in clinic and prescribed a one-week course of oral prednisone. A week later, no better, he saw his family physician and was given an antifungal cream. Within the week, he was seen at another walk-in clinic and given a topical corticosteroid.

The rash continued to get worse culminating in his visit to emergency where he was being treated with IV Solu-Medrol and antihistamines. He had the most severe case of pityriasis rosea PR I have ever seen. I discontinued his corticosteroids, prescribed a day course of erythromycin and a compounded cooling lotion containing 0. By then his itch had subsided. His rash cleared within five days. In this case, the initial treatment with oral corticosteroids had increased the severity of the disease so much that none of the physicians he saw subsequently were able to make a clinical diagnosis.

The etiology of PR is still not known. It may be a reaction to unknown triggers. Most cases are mild and resolve spontaneously without treatment. Recent studies have suggested an infectious etiology might be responsible. Both oral erythromycin and acyclovir have been reported to clear patients with severe disease 5. An older male patient, within hours of inadvertently ingesting one cloxacillin capsule, presented with fever, facial swelling, diffuse erythema and numerous pin-sized non-follicular pustules.

He was otherwise well. I suggested that he be admitted and observed overnight. That evening, I found an article describing a series of patients with the same presentation — an unusual and rare drug reaction designated as acute generalized exanthematous pustulosis. The good news, it resolves spontaneously within a few days. I stopped at the hospital early the next morning. I was too late; his physician had treated him with overnight with IV solu-medrol. Treating with topical corticosteroid is sometimes as effective for skin disease as the systemic drug:.

There is evidence to show that treating severe bullous diseases with potent topical corticosteroids can be as effective as treating with systemic. Topical treatment is very much safer as very little of the drug is absorbed even with open lesions.

Also, as the skin heals even less corticosteroid is absorbed. Bullous pemphigoid most common in elderly patients is now often treated with topical corticosteroids alone or in combination with high doses of tetracycline and niacinamide 6,7.

Patients who may require systemic corticosteroids include patients with severe or unresponsive disease or those intolerant to other treatment. Diseases most frequently treated include drug reactions, AD, nummular dermatitis, ACD, bullous pemphigoid and lichen planus. From: Murray Eileen, Diagnosing Skin Diseases: A diagnostic tool and educational resource for pediatricians and primary care givers. Note: Wet dressings are cool and soothing, antipruritic, and antiseptic.

They also enhance absorption of topical medications. They are the epitome of a treatment that always helps and never harms. For skin diseases with weeping or crusting a wet dressing open to the air dries the lesions. If the skin is dry an occluded wet dressing increases moisture retention. Physicians began using wet dressings several hundred years ago. Solutions were compounded by surgeons treating wounded soldiers.

Many lives were saved because the wet dressings greatly reduced the risk of infection. Karl August Burow, -a German surgeon, an inventor of both plastic surgery and wound healing techniques. Whether or not to use systemic corticosteroids to treat a skin disease.

View Results. Read More 2 Comments. The information presented here is interesting, but anecdotal. If I am to weigh the risk and benefit of offering oral steroids to my patients I need to get a sense of how likely such adverse events are. I agree with Dr. Murray that it is important to know that this complication happens in the 50mg per day dosing range, and I thank her for her contribution — but a decision to abandon a traditional and highly effective treatment requires a better sense of absolute risk.

The orthopaedic surgeon who put together the osteonecrosis case series discussed in this article sees a highly select population of those who suffer such complications. What was the denominator? Having written perhaps prescriptions for oral steroids I have never seen this complication — although clearly that is too small a sample size to be meaningful. The next time your local Division of Family Practice gets together count heads, and years of practice, and ask how many cases of osteonecrosis secondary to oral steroids the group has seen.

I thank Dr. Scott Garrison for his thoughtful comments. Statistics are not my thing so am not able to provide a sense of absolute risk. I do think that the large cohort study by Dr. Feng-Chen Kao provides compelling evidence for the association of systemic corticosteroid use with both fracture-related arthroplasty and fracture-unrelated surgery.

In a group of 21, users matched with non-users followed over 12 years, the hazard ratio HR was double for steroid users over non-users. The HR increased with increased steroid dosage, particularly in those with fracture-unrelated arthropathy. The adjusted HR increased from 3.

I think the most important point is that systemic corticosteroids are not a substitute for topical corticosteroids. They are a potent, broad-spectrum immunosuppressive agent and need to be prescribed with the same cautions you would use with any other immunosuppressive agent.

Topical corticosteroids are potent immunosuppressants but with normal use, rarely cause systemic symptoms. Our skin is an excellent barrier. I remember seeing a sixteen-year-old girl who had been prescribed clobetasol cream to treat her atopic dermatitis.

It cleared her disease. However, she continued to apply it to her skin every morning after her shower to prevent the eczema from coming back. She continued the daily treatment for a year. By that time, she had developed severe striae over her arms and legs. She was assessed by an endocrinologist and had no evidence of adrenal suppression. Notify me of followup comments via e-mail. You can also subscribe without commenting.

Whether or not to use systemic corticosteroids to treat a skin disease By Dr. Eileen Murray on October 3, Dr. What I did before When I started out in dermatology, corticosteroids were the only systemic drug available to treat patients with severe allergic contact dermatitis ACD , atopic dermatitis AD , drug reactions and those with bullous diseases. What changed my practice The following article made me change the way I treated ACD and stimulated me to try to avoid using systemic corticosteroids when at all possible.

What I do now 1. Allergic contact dermatitis: Each patient with ACD is instructed to apply a wet dressing 3,4 see Patient handout three times daily for 15 to 20minutes followed by the application of clobetasol propionate cream — the most potent topical corticosteroid.



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