Wednesday, February 14, 2007
Steroids Now for my pet peeve, steroid use for hive therapy. Many patients understandably get very concerned about their hives and turn to either emergency rooms or primary care physicians who may not be well versed on the subtleties of dermatological care. When patients are shot up with steroids and/or placed on short-term medrol dose packs, more often than not they exerience a worsened case of hives within a few days. This is called the rebound phenomenon. You may have read about it in some of my other newsletters. I almost never give systemic steroids for hives. Now if someone is in anaphylactic shock with their hives, epinephrine as well as steroids and huge doses of antihistamines are certainly appropriate medical management, but fortunately, most individuals are nowhere near that sick.