Another approach to treatment of small areas of vitiligo is the use of topical creams . These include corticosteroid creams or the topical immunomodulator, tacrolimus. Using medium and high strength topical corticosteroids for 1-4 months has been found to be the most effective and safest therapy for localized vitiligo. Steroid injections have also been used for the treatment of vitiligo. Steroids can be used twice daily for limited periods of time. Repigmentation of the vitiliginous area with topical corticosteroids is most likely to occur on hair bearing areas of the skin. However, corticosteroids should not be used for long periods of time, since they may lead to thinning of the skin, growth of blood vessels, and rashes.
Eczema is a chronic condition that is not curable. However, with a well integrated, medically monitored plan of care, symptoms can be effectively controlled, and people with eczema can lead active, comfortable lives. A good treatment plan is individualized to a person's medical history, specific type and severity of eczema, the specific cause, and other factors. A combination of treatments that include lifestyle changes with medications and other treatments as appropriate is the most effective way to best control eczema. Treatment of eczema includes prevention of flare-ups by avoiding exposure to irritants and allergens and minimizing skin dryness. Typical skin irritants and allergens include soaps, chemicals, cleaning products, weeds, and some metals, such as nickel. Skin dryness can be avoided or treated by using a perfume-free moisturizer, avoiding scratchy clothes, and using a home humidifier. Other important steps include avoiding alcohol and caffeine, using mild soaps, not over washing or scrubbing skin, and avoiding hot tubs, steam baths, saunas and chlorinated swimming pools. Ice bags or cool wet compresses may be helpful to help relieve itching. Therapy can also include taking an oatmeal bath and using oatmeal soap, such as Aveeno. More severe cases of itching and eczema may be treated with a corticosteroid cream, which reduces inflammation and an antihistamine, which reduces itching. These medications can have side effects, so they should only be taken under the direction of a health care clinician. Antibiotics may be prescribed to treat secondary bacterial infections. Another type of treatment that may be effective for some people with eczema is phototherapy.
Classical dermatomyositis patients are also at risk for certain internal medical complications. One such problem is the development of different types of cancers inside the body. When women with dermatomyositis develop internal cancer, they most commonly develop ovarian, breast, uterine, colon, rectum, and lung cancers. Men more often develop lung, colon, rectum, testicular cancers. Older individuals (> 50 years of age) and those having a extensive skin rash are at the greatest risk for developing cancer. In this setting, approximately 1 in 4 classical dermatomyositis patients develop some type of internal cancer within 2 years before to 2-4 years after the onset of their dermatomyositis. It is not yet known if patients with clinically-amyopathic dermatomyositis have an equally high risk of developing internal cancers. However, such individuals should have the same type of cancer evaluation as those with classical dermatomyositis until more information is available concerning this risk.