Jon M. Hanifin, MD

Oregon Health & Science University
Portland, OR

NEA Scientific Advisory Committee Member

 

 

 

Smallpox - Atopic Dermatitis and Smallpox Vaccination

People with atopic dermatitis (AD) tend to have a mild immune defect in their skin that occasionally allows certain viruses such as herpes simplex, warts, molluscum contagiosum and vaccinia (the live virus used for immunizing against smallpox) to spread over the skin.

How often should I be applying topical steroids?

Q:  How often should I be applying topical steroids?

A:  Topical corticosteroids are a mainstay of eczema therapy. Sadly, results are often suboptimal because of steroid phobia and mistakes in applying the steroids. The drugs are safe if we focus on two crucial factors: Frequency and Duration.

Here are some suggestions for proper use of topical corticosteroids:
* Apply to hydrated skin (after bath, shower or wet compresses).
* Generally speaking, and based on your doctor’s directions, begin with twice daily applications for durations of NO more than 3 days for face, eyelids, neck and folds 7 to

What do I need to know to use topical steroids correctly?

Q:  Sometimes I don’t follow my doctor’s directions concerning my eczema and steroid medications. What do I need to know to use topical steroids correctly?

A:  Managing eczema is confusing; details are important. Doctors complain that patients don’t follow advice. Probably just as often, patients don’t understand what was advised. It’s best to plan a follow-up visit one to two weeks after a steroid is prescribed to clarify instructions and enhance control of eczema if possible. Ask questions and demand clear answers.

Here are some common mistakes to be aware of in topical steroid therapy:
* Not

My doctor prescribed topical steroids for my eczema, but I am concerned about using them?

Q:  My doctor prescribed topical steroids for my eczema, but I am concerned about using them. Any suggestions?

A:  Topical corticosteroids are often the only reasonable therapy for controlling eczema. They are very effective and, if used properly, very safe. A major reason for failure is when there is an inappropriate prescription of low-potency steroids and the starting and stopping of regimens that never really control and stabilize the inflammation.

Hand Eczema

Q:  Aside from dry skin all over my body. The main place I get eczema is on my hands. When I have a flare up it seems to start with small (1-2 centimeter), clear-fluid, blister-type bubbles on my hands. The bubbles pop, the skin underneath is exposed, and the eczema starts. It takes about 7 to 10 days to heal—sometimes more, sometimes less. This depends on how much care I give it. That clear fluid blister that formed comes from something inside my body. Can you help me understand this? What is that clear fluid? I think it may be histamine. What causes it to come out on my hands?

What causes a person to get eczema on his or her body?

Q:   What causes a person to get eczema on his or her body? How can the terrible itch be helped? Are they working on a cure for this awful stuff?

A:   Atopic dermatitis is the most common type of eczema and has a genetic basis. Recently discovered genetic defects in the skin barrier seem to account for many, if not most, cases. The defective barrier allows chemical and physical irritants and bacterial toxins to trigger inflammation that causes redness and itching.