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  1. Article ; Online: Ethical use of topical corticosteroids

    Abir Saraswat

    Indian Journal of Dermatology, Vol 59, Iss 5, Pp 469-

    2014  Volume 472

    Abstract: Dermatologists rely very heavily on corticosteroids for treating many common dermatoses. Concerns about their incorrect use are widely expressed both in lay public and specialist discourse. From the point of view of medical ethics, issues of autonomy, ... ...

    Abstract Dermatologists rely very heavily on corticosteroids for treating many common dermatoses. Concerns about their incorrect use are widely expressed both in lay public and specialist discourse. From the point of view of medical ethics, issues of autonomy, beneficence and non-maleficence are all raised frequently when we prescribe topical corticosteroids to our patients. We need to be aware of situations when conflicts between these issues arise and have a clear thought process about resolving them. This can only be achieved if we have a thorough understanding of the skin disease being treated coupled with expertise in the use of the varied potencies and available dosage forms of topical corticosteroids. A good understanding of human psychology and effective communication is also needed to use these agents optimally.
    Keywords Adverse effects ; medical ethics ; topical corticosteroids ; Medicine ; R ; Dermatology ; RL1-803
    Publishing date 2014-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Ethical use of topical corticosteroids

    Abir Saraswat

    Indian Journal of Dermatology, Vol 59, Iss 5, Pp 469-

    2014  Volume 472

    Abstract: Dermatologists rely very heavily on corticosteroids for treating many common dermatoses. Concerns about their incorrect use are widely expressed both in lay public and specialist discourse. From the point of view of medical ethics, issues of autonomy, ... ...

    Abstract Dermatologists rely very heavily on corticosteroids for treating many common dermatoses. Concerns about their incorrect use are widely expressed both in lay public and specialist discourse. From the point of view of medical ethics, issues of autonomy, beneficence and non-maleficence are all raised frequently when we prescribe topical corticosteroids to our patients. We need to be aware of situations when conflicts between these issues arise and have a clear thought process about resolving them. This can only be achieved if we have a thorough understanding of the skin disease being treated coupled with expertise in the use of the varied potencies and available dosage forms of topical corticosteroids. A good understanding of human psychology and effective communication is also needed to use these agents optimally.
    Keywords Adverse effects ; medical ethics ; topical corticosteroids ; Medicine ; R ; Dermatology ; RL1-803
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Contact allergy to topical corticosteroids and sunscreens

    Abir Saraswat

    Indian Journal of Dermatology, Venereology and Leprology, Vol 78, Iss 5, Pp 552-

    2012  Volume 559

    Abstract: Topical corticosteroids and sunscreens are extensively used formulations, both as over-the-counter products and as prescription medicines. Topical corticosteroids are increasingly being recognized as causes of allergic contact dermatitis. Because of ... ...

    Abstract Topical corticosteroids and sunscreens are extensively used formulations, both as over-the-counter products and as prescription medicines. Topical corticosteroids are increasingly being recognized as causes of allergic contact dermatitis. Because of their anti-inflammatory property, contact allergy to these agents may be difficult to suspect and prove. With corticosteroid allergy, there are special issues in patch testing that need to be considered: Screening tests need to be done with budesonide and tixocortol pivalate, and delayed readings are essential to pick up all positive cases. Preventive advice needs to be tailored according to the structural and chemical peculiarities of a particular molecule. Sunscreen allergy is a significant part of cosmetic allergy; especially in cases of photoallergic reactions. Each passing decade is bringing forth new allergens in this class. In many countries, benzophenones have recently been replaced by octocrylene as the leading causes of contact dermatitis to sunscreens. This article provides a broad overview of corticosteroid and sunscreen allergy so that the readers are aware of these important emerging classes of allergens.
    Keywords Contact allergy ; sunscreens ; topical corticosteroids ; Dermatology ; RL1-803 ; Medicine ; R
    Language English
    Publishing date 2012-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Sudden irreversible worsening of myopia with isotretinoin treatment

    Abir Saraswat

    Indian Journal of Dermatology, Venereology and Leprology, Vol 77, Iss 5, Pp 611-

    2011  Volume 612

    Keywords Dermatology ; RL1-803 ; Medicine ; R
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Diagnosis and management of chronic pruritus

    Murlidhar Rajagopalan / Abir Saraswat / Kiran Godse / D S Krupa Shankar / Sanjiv Kandhari / Shrutakirthi D Shenoi / Sushil Tahiliani / V Vijay Zawar

    Indian Journal of Dermatology, Vol 62, Iss 1, Pp 7-

    An expert consensus review

    2017  Volume 17

    Abstract: The aim of this study is to formulate the best clinical practice in the diagnosis and management of chronic pruritus (CP). We searched PubMed, EMBASE, Scopus, Web of Science, and the WHO's regional databases, for studies on “Diagnosis and management of ... ...

    Abstract The aim of this study is to formulate the best clinical practice in the diagnosis and management of chronic pruritus (CP). We searched PubMed, EMBASE, Scopus, Web of Science, and the WHO's regional databases, for studies on “Diagnosis and management of chronic pruritus” from January 1, 2014, to July 31, 2015. We included programmatic reports and hand-searched references of published reviews and articles. Two independent reviewers screened articles and extracted data. We screened 87 of 95 studies that contained qualitative data. Avoid: Dry climate, heat, alcohol compress, ice packs, frequent bathing and washing, intake of very hot and spicy food, intake of alcohol, contact with irritant substances, excitement, strain and stress, and allergens. Using: Mild nonalkaline soaps, moisturizers, bathing oils, lukewarm water while bathing, soft cotton clothing and night creams/lotions, relaxation therapy, autogenic training, psychosocial education, educating patients to cope with itching and scratching, and educational programs. Especially use of moisturizers is considered important. In addition, symptomatic treatment options include systemic H1 antihistamines and topical corticosteroids. Symptomatic therapy directed toward the cause (hepatic, renal, atopic, polycythemia, etc.). If refractory or cause is unknown, consider capsaicin, calcineurin inhibitors for localized pruritus and naltrexone, pregabalin, ultraviolet therapy, Cyclosporine for generalized itching. CP is quite frequent finding associated with skin and systemic diseases in the overall population. It is known to significantly affect quality life score of an individual and also adds burden on the health-care cost. A specific recommendation for treatment of CP is difficult as a result of varied and diverse possibility of underlying diseases associated with CP.
    Keywords Chronic pruritus ; Consensus ; Management of Chronic pruritus ; Medicine ; R ; Dermatology ; RL1-803
    Subject code 610
    Language English
    Publishing date 2017-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Tretinoin Nanogel 0.025% Versus Conventional Gel 0.025% in Patients with Acne Vulgaris

    B S Chandrashekhar / M. Anitha / Mukesh Ruparelia / Pradyumna Vaidya / Riyaz Aamir / Sunil Shah / S Thilak / Sanjeev Aurangabadkar / Sandeep Pal / Abir Saraswat / Jayesh J Sanmukhani

    Journal of Clinical and Diagnostic Research, Vol 9, Iss 1, Pp WC04-WC

    A Randomized, Active Controlled, Multicentre, Parallel Group, Phase IV Clinical Trial

    2015  Volume 09

    Abstract: Background: Conventional topical tretinoin formulation is often associated with local adverse events. Nanogel formulation of tretinoin has good physical stability and enables good penetration of tretinoin into the pilo-sebaceous glands. Aim: The present ... ...

    Abstract Background: Conventional topical tretinoin formulation is often associated with local adverse events. Nanogel formulation of tretinoin has good physical stability and enables good penetration of tretinoin into the pilo-sebaceous glands. Aim: The present study was conducted to assess the efficacy and safety of a nanogel formulation of tretinoin as compared to its conventional gel formulation in the treatment of acne vulgaris of the face. Materials and Methods: This randomized, active controlled, multicentric, phase IV clinical trial evaluated the treatment of patients with acne vulgaris of the face by the two gel formulations locally applied once daily at night for 12 wk. Acne lesion counts (inflammatory, non-inflammatory & total) and severity grading were carried out on the monthly scheduled visits along with the tolerability assessments. Results: A total of 207 patients were randomized in the study. Reductions in the total (72.9% vs. 65.0%; p = 0.03) and inflammatory (78.1% vs. 66.9%; p = 0.02) acne lesions were reported to be significantly greater with the nanogel formulation as compared to the conventional gel formulation. Local adverse events were significantly less (p = 0.04) in the nanogel group (13.3%) as compared to the conventional gel group (24.7%). Dryness was the most common adverse event reported in both the treatment groups while peeling of skin, burning sensation and photosensitivity were reported in patients using the conventional gel only. Conclusion: In the treatment of acne vulgaris of the face, tretinoin nanogel formulation appears to be more effective and better tolerated than the conventional gel formulation.
    Keywords acne vulgaris ; nanogel ; tretinoin ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher JCDR Research and Publications Private Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Topical corticosteroid abuse on the face

    Abir Saraswat / Koushik Lahiri / Manas Chatterjee / Shyamanta Barua / Arijit Coondoo / Asit Mittal / Saumya Panda / Murlidhar Rajagopalan / Rajeev Sharma / Anil Abraham / Shyam B Verma / C R Srinivas

    Indian Journal of Dermatology, Venereology and Leprology, Vol 77, Iss 2, Pp 160-

    A prospective, multicenter study of dermatology outpatients

    2011  Volume 166

    Abstract: Background: Abuse of topical corticosteroids (TC), especially over the face, is prevalent worldwide, including in India. Data about the magnitude of this problem in our country is lacking. Aims: The aims of this study were to ascertain the demographics, ... ...

    Abstract Background: Abuse of topical corticosteroids (TC), especially over the face, is prevalent worldwide, including in India. Data about the magnitude of this problem in our country is lacking. Aims: The aims of this study were to ascertain the demographics, magnitude and clinical features of TC misuse on the face in the dermatology outpatient department (OPD) attendees in order to raise awareness about this problem and to analyze its causes. Methods: This was a prospective multicenter questionnaire-based clinical study conducted at 12 dermatology centers nationwide. Patients with relevant facial dermatoses reporting to the investigator were asked about their current use of over-the-counter topical formulations and a structured questionnaire applied in case the same was confirmed to be TC. Results: A total of 2926 patients with facial dermatoses were screened, of which 433 (14.8%) were using TC. TC was used as a fairness/general purpose cream or aftershave in 126 (29%) and in 104 (24%) for acne. Steroid combinations were used by 258 (59.6%). Potent and super-potent TC were significantly (P = 0.05) more frequently used by the rural/suburban population. The younger age groups used more potent formulations. A non-physician recommendation for TC use was obtainable in 257 (59.3%) patients. Of these, 232 (90.3%) were for potent/super-potent steroids. Among 176 physician prescriptions, 78 (44.3%) were from non-dermatologists. All non-physician prescriptions and 146 (83%) physician prescriptions for TC were inappropriately refilled. Adverse effects were seen in 392 (90.5%) TC users. Acne/exacerbation of acne was the most common adverse effect. Conclusions: TC misuse in patients with facial dermatoses is quite common, and most of this use is unwarranted. Use as a fairness cream is the most common indication in this cohort. Limitations: This was an OPD-based study and, therefore, it may or may not accurately reflect the community data.
    Keywords Abuse ; adverse effects ; potent ; topical steroid damaged face ; Dermatology ; RL1-803 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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