Therapy with systemic
corticosteroids, despite attendant serious risks, is mandatory in diseases such as
pemphigus, acute disseminated lupus erythematosus and some cases of
exfoliative dermatitis that are ordinarily fatal, for in such cases life may be prolonged and the patients made comfortable. If no
contraindications exist,
therapy with
corticosteroids is desirable, for diseases of short duration-
contact dermatitis,
serum sickness reactions and
drug eruptions of all kinds-provided the causative factors have been removed and the reactions are causing severe distress.On the basis of encouraging reports in the literature
corticosteroid therapy may be instituted with justification for a group of unrelated, intractable and discomforting diseases such as maddening
pruritus ani,
sclerema neonatorum,
dermatomyositis, certain cases of
sarcoidosis,
berylliosis,
Behcet's syndrome, universal
calcinosis,
Reiter's disease and
ulcers of
sickle-cell anemia. One must always bear in mind the well-defined
contraindications to
corticosteroid therapy and the hazards of its use, particularly if
therapy is to be prolonged. Results from topical
hydrocortisone therapy are particularly pleasing in chronic eczematous
otitis externa and especially when it is combined with an
antibiotic drug. Results are excellent also in nuchal
eczema,
dermatitis of the eyelids and in
pruritus ani. More often than not,
hydrocortisone ointment and lotions benefit more than do other standard remedies such diseases as
atopic eczema,
contact dermatitis,
lichen simplex-chronicus and eczematized phases of conditions such as
psoriasis and superficial mycotic
infections. Preparations containing a combination of
hydrocortisone and an
antibiotic are more useful than
hydrocortisone alone. When used with discrimination, with full attention to the selection of cases and proper concentration in the correct vehicle,
hydrocortisone preparations in combination with
antibiotics are excellent antieczematous agents.