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My topical therapy with steroids is not working. Why?

My topical therapy with steroids is not working. Why?

When an inflammatory skin condition fails to respond to topical steroid therapy, the following factors need to be considered:

-Co-existing infection (bacterial, fungal, viral, scabies etc.)
-Wrong diagnosis (e.g. drug eruption, Pagets disease, mycosis fungoides mistaken as eczema)
-Insufficient potency of steroid for the site or skin condition.
-Inappropriate vehicle or base (e.g. cream is not as effective as ointment for dry lichenifed skin. Adding salicylic acid acts as a keratolytic and aids penetration of hyperkeratotic palms and soles)
-Poor compliance or incorrect method of application and skin care
-Irritant contact dermatitis: due to overexposure to water, detergents, lotions, antiseptics, herbal remedies.
-Allergic contact dermatitis: allergens such as metal, rubber, glue, and medicaments such as a steroid.

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My topical therapy with steroids is not working. Why?
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