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Dermatitis - contact - Management
What should I consider before prescribing an oral corticosteroid?
- There is no evidence to guide the optimum dose and duration of oral corticosteroids in an acute episode of contact dermatitis. Some experts recommend prednisolone 0.5–1 mg/kg/day, given for 5–7 days and then tapered over 2–3 weeks (according to response) to prevent rebound dermatitis [Beltrani et al, 2006; Mark and Slavin, 2006; Jacob and Castanedo-Tardan, 2007].
- The frequent or prolonged use of systemic corticosteroids is associated with serious adverse effects, including growth retardation in children, diabetes mellitus, high blood pressure, and osteoporosis. However, these are unlikely to be a problem with a single, short course of prednisolone. Consider referral:
- If more than very occasional use is needed (e.g. more than one course in a year).
- For children younger than 16 years of age.
- Do not prescribe an oral corticosteroid if continued exposure to the allergen cannot be avoided.
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