Sarah Hyland Gets Real About Dealing With Prednisone ‘Moon Face’
Prednisone is a commonly prescribed synthetic hormone drug, but it can cause a ton of unpleasant side effects.
Prednisone is a commonly prescribed synthetic hormone drug, but it can cause a ton of unpleasant side effects.
THROUGHOUT my childhood and young adult years, I was oblivious to poison ivy, bragging that I did not seem to get it even after traipsing through patches of it that caused my kid brother perennial agony. I had no reason, I thought, even to bother …
Sweet’s syndrome (SS), or acute febrile neutrophilic dermatosis is a skin disease characterized by the sudden onset of fever, an elevated white blood cell count, and tender, red, well-demarcated papules and plaques that show dense infiltrates by neutrophil granulocytes on histologic examination.
The syndrome was first described in 1964 by Robert Douglas Sweet. It was also known as Gomm-Button disease in honour of the first two patients Sweet diagnosed with the condition.
Pustular lesions with central necrosis on the left leg of a patient with Sweet’s syndrome associated with Crohn’s disease.
Punch biopsy of a skin lesion showing neutrophilic infiltration in the dermis, with no evidence of vasculitis (same patient with Crohn’s disease).
Acute, tender, erythematous plaques, nodes, pseudovesicles and, occasionally, blisters with an annular or arciform pattern occur on the head, neck, legs, and arms, particularly the back of the hands and fingers. The trunk is rarely involved. Fever (50%); arthralgia or arthritis (62%); eye involvement, most frequently conjunctivitis or iridocyclitis (38%); and oral aphthae (13%) are associated features.
SS can be classified based upon the clinical setting in which it occurs: classical or idiopathic SS, malignancy-associated SS, and drug-induced SS.
SS is a reactive phenomenon and should be considered a cutaneous marker of systemic disease. Careful systemic evaluation is indicated, especially when cutaneous lesions are severe or hematologic values are abnormal. Approximately 20% of cases are associated with malignancy, predominantly hematological, especially acute myelogenous leukemia (AML). An underlying condition (streptococcal infection, inflammatory bowel disease, nonlymphocytic leukemia and other hematologic malignancies, solid tumors, pregnancy) is found in up to 50% of cases. Attacks of SS may precede the hematologic diagnosis by 3 months to 6 years, so that close evaluation of patients in the “idiopathic” group is required.
There is now good evidence that treatment with hematopoietic growth factors — including granulocyte colony-stimulating factor (G-CSF), which is used to treat AML, and granulocyte-macrophage colony-stimulating factor — can cause SS. Lesions typically occur when the patient has leukocytosis and neutrophilia but not when the patient is neutropenic. However, G-CSF may cause SS in neutropenic patients because of the induction of stem cell proliferation, the differentiation of neutrophils, and the prolongation of neutrophil survival.
Although it may occur in the absence of other known disease, SS is often associated with hematologic disease (including leukemia), and immunologic disease (rheumatoid arthritis, inflammatory bowel disease, Behçet’s syndrome).
A genetic association has been suggested, but no specific genetic link has been identified.
The clinical differential diagnosis includes pyoderma gangrenosum, infection, erythema multiforme, adverse drug reactions, and urticaria. Recurrences are common and affect up to one third of patients.
Studies show a moderate neutrophilia (less than 50%), elevated ESR (greater than 30 mm/h) (90%), and a slight increase in alkaline phosphatase (83%). Skin biopsy shows a papillary and mid-dermal mixed infiltrate of polymorphonuclear leukocytes with nuclear fragmentation and histiocytic cells. The infiltrate is predominantly perivascular with endothelial-cell swelling in some vessels, but vasculitic changes (blood clots; deposition of fibrin, complement, or immunoglobulins within the vessel walls; red blood cell extravasation;inflammatory infiltration of vascular walls) are absent in early lesions.
Perivasculitis occurs secondarily, because of cytokines released by the lesional neutrophils. True transmural vasculitis is not an expected finding histopathologically in SS.
Sweet described a disease with four features: fever; leukocytosis; acute, tender, red plaques; and a papillary dermal infiltrate of neutrophils. This led to the name acute febrile neutrophilic dermatosis. Larger series of patients showed that fever and neutrophilia are not consistently present. The diagnosis is based on the two constant features, a typical eruption and the characteristic histologic features; thus the eponym “Sweet’s syndrome” is used.
Systemic corticosteroids such as (prednisone) can produce rapid improvement and are the “gold standard” for treatment. The temperature, white blood cell count, and eruption improve within 72 hours. The skin lesions clear within 3 to 9 days. Abnormal laboratory values rapidly return to normal. There are, however, frequent recurrences. Corticosteroids are tapered within 2 to 6 weeks to zero.
Resolution of the eruption is occasionally followed by milia and scarring. The disease clears spontaneously in some patients. Topical and/or intralesional corticosteroids may be effective as either monotherapy or adjuvant therapy. Oral potassium iodide or colchicine may induce rapid resolution.
Patients who have a potential systemic infection or in whom corticosteroids are contraindicated can use these agents as a first-line therapy. In one study, indomethacin, 150 mg per day, was given for the first week, and 100 mg per day was given for 2 additional weeks. Seventeen of 18 patients had a good initial response; fever and arthralgias were markedly attenuated within 48 hours, and eruptions cleared between 7 and 14 days.
Patients whose cutaneous lesions continued to develop were successfully treated with prednisone (1 mg/kg per day). No patient had a relapse after discontinuation of indomethacin. Other alternatives to corticosteroid treatment include dapsone, doxycycline, clofazimine, and cyclosporine. All of these drugs influence migration and other functions of neutrophils.
Reactive neutrophilic dermatoses
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Went to the doctor today to get something for my poison ivy. They finally gave me a script for some prednisone. I’m already feeling better.
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Triamcinolone acetonide is a synthetic corticosteroid used topically to treat various skin conditions, to relieve the discomfort of mouth sores and intra-articularly by proceduralists to treat various joint conditions. In nasal spray form, it is used to treat allergic rhinitis. It is a more potent derivative of triamcinolone, and is about eight times as potent as prednisone.
It is also known under the brand names Kenalog (topical) and Volon A as an injection, to treat allergies, arthritis, eye diseases, intestinal problems, and skin diseases. There are possible risks from an injection. It has been known to cause fat and muscle loss at an injection site, leaving a large divot bone deep.
In 2014, the FDA made triamcinolone acetonide an over-the-counter drug in the United States in nasal spray form under the brand name Nasacort.
Triamcinolone acetonide as an intra-articular injectable has been used to treat a variety of musculoskeletal conditions. When applied as a topical ointment, applied to the skin, it is used to mitigate blistering from poison ivy, oak, and sumac,. When combined with Nystatin, it is used to treat skin infections with discomfort from fungus, though it should not be used on the eyes, mouth, or genital area. It provides relatively immediate relief and is used before using oral prednisone. Oral and dental paste preparations are used for treating aphthous ulcers.
As an intravitreal injection, triamcinolone acetonide has been used to treat various eye diseases and has been found useful in reducing macular edema. Drug trials have found it to be as efficient as anti-VEGF drugs in eyes with artificial lenses over a two-year period. A systematic review did not find any evidence of any benefit in preventing vision loss in eyes treated with triamcinolone acetonide over placebo, for patients with age-related macular degeneration.
Uncommonly, intramuscular injection of triamcinolone acetonide may be indicated for the control of severe or incapacitating allergic states for which conventional treatments have failed, such as asthma, atopic dermatitis, contact dermatitis, perennial or seasonal allergic rhinitis, serum sickness, and transfusion and drug hypersensitivity reactions.
As with all immunosuppressant drugs, triamcinolone acetonide should not be taken by persons suffering from infectious diseases, either currently or in recuperation or soon thereafter. Contact with infectious persons should be avoided during the entire course of treatment. Users who contract an infection during their regimen should contact their doctors to discuss whether to discontinue triamcinolone acetonide.
Triamcinolone acetonide should not be taken if the patient is also taking any other steroid or immunosuppressant, or if they have recently undergone any medical procedures involving the administration of steroids (e.g. nerve block).
Evidence suggests that usage of traimcinolone acetonide or other steroids to treat macular edema increases the risk of increasing intraocular pressure in patients.
Many drugs have been demonstrated to increase triamcinolone acetonide concentration in the blood to well above the intended level. Patients should inform doctors about any other drugs they are taking.
Triamcinolone acetonide should not be used by those with tuberculosis or untreated fungal, bacterial, systemic viral or herpes simplex infections without consulting a doctor first.
Triamcinolone acetonide is a corticosteroid. It is specifically a glucocorticoid, or an agonist of the glucocorticoid receptor.
See also: List of corticosteroids
Triamcinolone acetonide, also known as 9α-fluoro-16α-hydroxyprednisolone 16α,17α-acetonide or as 9α-fluoro-11β,16α-17α,21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with acetone, is a synthetic halogenated cyclic ketal pregnane corticosteroid. It is the C16α,17α acetonide of triamcinolone.
Triamcinolone acetonide is also used in veterinary medicine as an ingredient in topical ointments and in topical sprays for control of pruritus in dogs. A series of injections with triamcinolone acetonide or another corticosteroid may reduce keloid size and irritation. It is used as a preinductor and/or inductor of birth in cows. It is also used in the horse racing industry, it being a banned substance if found in a horse’s system on race day.
Glucocorticoid receptor modulators
Mineralocorticoids and antimineralocorticoids
List of corticosteroids
Glucocorticoids and antiglucocorticoids
Mineralocorticoid receptor modulators
List of corticosteroids
Scleroderma is a disease that involves the buildup of scar-like tissue in the skin. It also damages the cells the line the walls of the small arteries.
Prednisone isn’t soluble in water, and so is unable to be given intravenously. It is a prodrug that is converted by the liver into prednisolone, which is the active drug and also a steroid. The medication Prednisone exists as a kind of glucocorticoid.
Prednisone is called glucocorticoids, for the reason that they are armed. Along with its needed effects, it may cause some unwanted effects. Academy prednisone taper order destined to reside despite the grossest negligence is prednisone for dogs the very same as humans can likewise be excited by the movements of the individual.
When you’re on prednisone, your skin will usually clear up inside a few days. Prednisone is a steroid that’s utilized to prevent inflammation. It is a type of oral corticosteroids that is used to reduce inflammation.
Prednisone was know to result in long-term effects which itas advisable to completely understand to give you the absolute most informed decision when looking at using the drug. It can also be used to treat sarcoid rash, but it may cause the thinning of the skin. It should only be given by the right people who know what they are doing (which is, most of the times, your veterinarian) and for just the right amount of time, or else serious side effects will take place. Prednisone should only be given by the most suitable individuals who are aware of what they are doing (which is, the majority of the times, your veterinarian) and for just the correct quantity of time, or else significant prednisone side effects in dogs will occur.
A 100 mg Rimadyl pill approximately 19 mm (0.75 in) wide and 8.6 mm (0.34 in) thick, sold in the United States
Carprofen, marketed under many brand names worldwide, is a nonsteroidal anti-inflammatory drug (NSAID) that veterinarians prescribe as a supportive treatment for various conditions in animals. It provides day-to-day treatment for pain and inflammation from various kinds of joint pain as well as post-operative pain. Carprofen reduces inflammation by inhibition of COX-1 and COX-2; its specificity for COX-2 varies from species to species.
Most dogs respond well to carprofen use, but like all NSAIDs, it may cause gastrointestinal, liver and kidney problems in some patients.
After introduction, significant anecdotal reports of sudden animal deaths from its use arose. To date[when?], the FDA has received more than 6,000 adverse reaction reports about the drug (manufactured by Pfizer). As a result, the FDA requested that Pfizer advise consumers in their advertising that death is a possible side effect. Pfizer refused and pulled their advertising; however, they now include death as a possible side effect on the drug label. Plans call for a “Dear Doctor” letter to advise veterinarians, and a safety sheet attached to pill packages.
Adverse effects include:
Effects of overdose include gastritis and ulcer formation.
In healthy dogs given carprofen, no perioperative adverse effects on the cardiovascular system have been reported at recommended dosages.  Perioperative administration of carprofen to cats did not effect postoperative respiratory rate nor heart rate.
Carprofen should not be administered concurrently with steroids, as this can cause ulcers in the stomach. Dogs should be taken off carprofen for three full days before ingesting a steroid (such as prednisolone). Carprofen should not be given at the same time with other types of medications such as other NSAIDs (aspirin, etodolac, deracoxib, meloxicam, tepoxalin) or steroids such as dexamethasone, triamcinolone, cortisone or prednisone.
Carprofen must be used with caution within the supervision of a veterinarian in dogs with liver or kidney disease, dehydration, bleeding deficits, or other health problems. It is not recommended for use in dogs with bleeding disorders (such as Von Willebrand’s disease), as safety has not been established in dogs with these disorders. It has not been established whether carprofen can be safely used in pregnant dogs, dogs used for breeding purposes, or in lactating female dogs.
Several laboratory studies and clinical trials have been conducted to establish the safety of using Carprofen. Clinical studies were conducted in nearly 300 dogs, coming from different breeds. The dogs were treated with Rimadyl at the recommended dose for 2 weeks. According to these studies, the drug was clinically well tolerated and the treated dogs did not have a greater incidence of adverse reactions when compared to the control group.
A number of factors that may contribute to the high incidence of adverse reports received for carprofen by the Center for Veterinary Medicine in the late 1990s. These include:
Carprofen was used in humans for almost 10 years, starting in 1988. It was used for the same conditions as in dogs, viz., joint pain and inflammation. Side effects tended to be mild, usually consisting of nausea or gastro-intestinal pain and diarrhea. Carprofen was available only by prescription in 150 to 600 mg doses. Dosage over 250 mg was only for relieving pain after severe trauma, such as post-surgery inflammation. 150 mg doses were commonly used to relieve the pain of arthritis, while 200 mg doses were commonly prescribed in cases of severe arthritis or severe inflammation pain. The drug was taken orally. Pfizer voluntarily removed it from the market for human use on commercial grounds.
Carprofen may be administered intravenously to horses. A single dose has been shown to reduce prostaglandin E2 production and inflammatory exudate for up to 15 hours, although there was less effect on eicosanoid production when compared to the effects produced by NSAIDs such as phenylbutazone or flunixin. Prostaglandin E2 and inflammatory exudate are also reduced and leukotriene B4 is inhibited. Carprofen can also be given orally, but intramuscular use may produce muscle damage.
It is marketed under many brand names including: Acticarp, Austiofen, Bomazeal, Canidryl, Carporal, Carprieve , Carprocow, Carprodolor, Carprodyl, Carprofelican, Carprofen, Carprofène, Carprofeno, Carprofenum, Carprogesic, Carprosol, Carprotab, Carprox, Comforion, Dolagis, Dolocarp, Dolox, Eurofen, Kelaprofen, Librevia, Norocarp, Norodyl, Novocox, Prolet, Reproval, Rimadyl, Rimifin, Rofeniflex, Rycarfa, Scanodyl, Tergive, Vetprofen, and Xelcor.
Veterinary dosage forms include 25 mg, 75 mg, and 100 mg tablets, and 50 mg per mL injectable form.
Leukotriene signaling modulators
Nuclear receptor modulators
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