In patients with the adrenogenital syndrome, a single intramuscular injection of 40 mg every two weeks may be adequate. For maintenance of patients with rheumatoid arthritis , the weekly intramuscular dose will vary from 40 to 120 mg. The usual dosage for patients with dermatologic lesions benefited by systemic corticoid therapy is 40 to 120 mg of methylprednisolone acetate administered intramuscularly at weekly intervals for one to four weeks. In acute severe dermatitis due to poison ivy, relief may result within 8 to 12 hours following intramuscular administration of a single dose of 80 to 120 mg. In chronic contact dermatitis, repeated injections at 5 to 10 day intervals may be necessary. In seborrheic dermatitis, a weekly dose of 80 mg may be adequate to control the condition.
Treatment is difficult. Due to the intensity of the itch patients often go from doctor to doctor looking for relief. No one treatment is always effective and several treatments may need to be tried. Initial treatment is often potent prescription steroid creams . If these help, a milder cream can be used for longer-term control. Antihistamine creams (Zonalon, Pramoxine) or pills (Atarax, Periactin) are often added for additional relief. Intralesional steroid injections , anti-depressant pills, and non-prescription capsaicin cream helps many of those not improved with the usual treatment.
These yellowish bumps on the skin can be very small or large. If they are numerous or atypical they should be checked by a dermatologist. Very unusually these lesions can be associated with colon problems and a colonoscopy might be worthwhile. All destructive treatments, shaving, Ellman radiosurgery/radiofrequency, electrodesiccation can result in some lesions becoming deeper than the normal surrounding skin. In expert hands, the very careful application of a very strong concentration of 100% trichloracetic acid may help flatten them. The only way to prevent the same lesion from regrowing would be to surgically excise it but that may leave an unsatisfactory result.