Are there evidence-based guidelines for using corticosteroids in treating anaphylaxis, acute allergic reactions, and severe contact dermatitis?
—Patricia Hoyecki, ARNP, FP, Medford, Ore.

Guidelines for the care of contact dermatitis were prepared for dermatologists on behalf of the British Association of Dermatologists (Br J Dermatol. 2001;145:877-885). The long-term intermittent use of topical corticosteroids (mometasone furoate) in chronic hand eczema was demonstrated in an open prospective randomized trial. The investigators who prepared the guidelines evaluated this trial and gave it a “1” quality of evidence (signifying that the evidence was obtained from at least one properly designed, randomized control trial) and a “B” strength of recommendation (implying that there was fair evidence to support use of the procedure).
—Philip R. Cohen, MD (103-15)

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