Topical Therapy Primer for Nondermatologists.

A representative assortment of topical therapies is discussed here with the goal of emphasizing the most commonly encountered diagnoses and treatments for nondermatologists. When using topical therapies, carefully consider the proper active ingredient, potency, vehicle, and quantity of medication. If topical therapy is ineffective, question whether the medication is being used properly, whether the diagnosis is correct, and whether the topical may be contributing to the problem. Examples of the topical contributing to the problem include tinea incognito exacerbated by topical steroid use and allergic contact dermatitis to topical steroid excipients. For some patients, even maximum topical therapy is insufficient and systemic treatment is required. At this point, consultation with a dermatologist may be helpful.