Interview #2: Dilyana Georgieva

14686207_1655613021418244_489976427_nDilyana Georgieva
Las Vegas, Nevada

1.When did you start using topical steroids? And why?

I started in the beginning of December 2015 because I had an eczema like spot on my left hand, which did not respond to any natural topical treatments. Later on I found that it was some food sensitivities that were causing the eczema.

2. What was the name of the topical steroid?

It was an over the counter steroid cream CVS’ pharmacy brand.

3. Were you ever prescribed more potent steroids? 

I did not ask my allergy doctor for a prescription and he did not suggest.

4. How did you find out about RSS?

The day I stopped using the cream my eczema exploded, or so I thought, so I Googled “topical steroids detoxification and healing” and I came across the ITSAN web site. I am so grateful to ITSAN and similar online recourses to find so early in the process what I have, what to expect, and in some extent how to cope with it.

5. What made you feel you had RSS?

Since it started, I have been fitting 100% to the clinical presentation of the condition with all symptoms and signs of it.

6. Were you diagnosed by a doctor? Did you have a supportive doctor?

I have not been diagnosed by a doctor because there is no one in my area of Las Vegas, NV who is familiar with the condition.

7. What were your first symptoms?

My rash exploded the same day I stopped the steroid cream to cover 3/4 of my arms and 3/4 of my legs including buttocks. I had immense burning, stinging, and flu like symptoms.

8. Is your family supportive? Friends?

Yes, it is supportive. I do not involve my friends in this.

9. Have you ever been to a hospital for this? 

No

10. What has been the hardest part of this condition?

Everything was hard and challenging from the physical pain, burning, stinging, itching, decreased range of motion, and fever to the emotional and mental suffering and isolation, the inability to exercise and socialize. This condition is a life altering event.

11. How long have you been in withdrawal? 

It started on 05/22/16 up to now.

12. What do you use as comfort measures during this?

I have been focused on the solutions instead of the problem. I had the appropriate mind set to cope with the TSW without succumbing to depression, self-pity, and a sense of helplessness. Mentally and emotionally, I was at the right place to be able to stay on the positive side of it. I credit that to the online recourses for the condition and my spirituality. I have created multiple self-care natural and organic cosmetic products to alleviate as much as possible the symptoms of itching, burning, pain, and inflammation. I kept myself busy and distracted from the TSW suffering to have the feeling of a decent, normal life. I practice daily relaxation and self-hypnosis which is a great tool when one has a struggle with a chronic condition.

13. Are you employed? Has this affected your job status?

I do not work outside of home due to another long lasting disability from Fibromyalgia.

14. Have you gone to therapy/wish to go to therapy because of this condition?

The only therapy I would like to try is mineral baths. However, I cannot tolerate traveling currently. I live in Las Vegas, NV. I am Bulgarian in origin and we have a number of mineral water resorts specialized in skin conditions treatment. These waters are similar to the famous Avene, France thermal mineral waters. The treatment there is much cheaper than in France.

15. If there is one thing you could say to another sufferer, what would it be?

I am aware that some TSW sufferers experience a much worse process and have their entire bodies affected. However, I would say that staying positive, focusing on solutions, trying to keep some things of their normal life routines, and employing relaxation and meditation techniques would be of great benefit to their recovery process. One book/audio book that has helped me through episodes of health struggles is The Power of Your Mind to Heal, by Joan Borysenko PhD.


Thank you Dilyana for your awesome interview!

Feature #4: Adele & Tessa

Adele Newmanadelenewman

Age: 30

Career: Barmaid

When did you cease using topical steroids: July 2015

What type did you use: Prednisone. Eumovate, Elecon, Betnovate,Trimovate.

What is your favorite product for comfort? Aveeno skin relief lotion and vaseline

What is the hardest thing to deal with during this condition? The pain and being unable to move somedays. Not being able to look after/do things with my 2 kids the way I used to.

What is the first thing you will do when healed? Take my kids swimming, do as much activities as I can with my kids, and treating myself to new clothes that don’t have to be cotton and long sleeved!


Topical Steroid Label

Whenever we purchase a prescription, there is always an insert or attached label outlining that specific drug’s usage. More often than not, we toss it into the trash. What we should be doing is taking the time to read the insert because it holds extremely valuable information. However, on the contrary, there is misguided information that needs to be looked at closely.

The following is seen on the insert for Clobetasol Propionate, a Class 1 Super Potent steroid:

In bold letters: do not use for more than 2 weeks, 50g per week, because it can suppress the HPA axis.

First off, it warns not use to this for more than 14 days. What it does not say is “Do not use for more than 14 days unless your doctor thinks it’s cool.” There is a definite reason why it states that warning despite what your doctor tells you.

HPA axis suppression is not something you, or your doctor, should take lightly. You are highly increasing your chances of developing Red Skin Syndrome and creating an imbalance in your adrenal glands.

Also, what does 50g a week mean to you? Most likely nothing because you are not a doctor and have no idea how to measure out 50g.

Let’s say your doctor gave you a tube that was 60g large, and their instructions were to “use on flaring areas once a day.” That was it. That was all they told you. Well, your thighs, hands, elbow area, and neck are flaring. These areas combined, using the fingertip method, come out to around 10g a day of use. 10g x 7 days = 70g a week. That is over the maximum limit of use.

But let’s take this further. In bold, the insert states:

“Precautions: General: Clobetasol Propionate is a highly potent topical corticosteroid that has been shown to suppress the HPA axis at doses as low as 2g per day.”

2g per day! That is around 4 fingertip units a day.

2g x 7 days a week = 14g a week. So, more accurately, 50g a week is WAY too much. Even if 14g a week is seen as the ‘minimum’ to cause HPA axis suppression, that means THERE IS A POSSIBILITY it can happen with just 14g a week, which in turn shows there is a LARGE POSSIBILITY it will happen at the ‘safe usage’ of 50g a week.

That 36g difference is remarkable. This is something that rarely ever gets explained in a doctor’s office. When a doctor gives you the instruction to “use sparingly”, this is what they should be explaining to you.

But let’s move on.

When using steroids, adults are not equal to children.

“Pediatric patients may be more susceptible to systemic toxicity from equivalent doses due to their large skin surface to body mass ratios.”

First off, the word systemic should bounce out. If any doctor tells you that topical steroids “are not systemic”, they are lying to you. Just because you are not orally using them, does not mean they do not penetrate our skin and enter our system.

And two, this should put up a huge warning flag. If 14g a week is the lowest dose they saw suppression in for adults, try halving that, or even one quarter. That would be between 4g and 8g a week for small children and babies. And, because they are smaller, there is a larger chance of suppression. Besides, in bold caps, the insert says, “Use in children under 12 years of age is not recommended.” If a doctor prescribes this to a child under 12, especially a baby, know that this recommendation should read more as a forbiddance.

“If concomitant skin infections are present or develop, an appropriate antifungal or antibacterial agent should be used. If a favorable response does not occur promptly, use of clobetasol propionate should be discontinued until the infection has been adequately controlled.”

First off, you’ve got the vague “promptly” in there. Give us actual numbers, perhaps, “1-2 days”. And secondly, you should NEVER use steroids on an infection. It will just make them worse. Check out Tinea Incognito.

“#5 Patients should inform their physicians that they are using clobetasol propionate if surgery in contemplated.”

I had never heard of this before, so I do hope this information is shared in the doctor’s office and not left for the patient to (not) read in the insert.

And last, but certainly not least, in lovely bold writing, “should not be used on the face, groin, or axiliae”. This isn’t a recommendation. This is a definite warning.

Interview #1: Joey VanDyke

JoAnne (Joey) VanDyke14364711_10208836120492432_2954530378884912840_n
Southwest Michigan

“Three things will last forever–faith, hope, and love–and the greatest of these is love” – Apostle Paul

When did you start using topical steroids? I don’t know exactly what age as I had eczema as a baby, but I’ve used it since childhood. My older sisters remember my mother rubbing some kind of cream on the inside of my knees and elbows and putting socks on my hands every night when I was young. I remember chewing holes in the socks to scratch.

What was the name of the topical steroid? I only remember a few names of TS since my eczema started in my infant days and my mother may have used them on me as well. Aristocort, Westcort, Kenalog and Triamcinalone.

Were you ever prescribed more potent steroids? I think the ones I was prescribed were pretty much the same strength as my fingers would clear well with the ones I used.



How did you find out about RSS? It took about five months of trying to fix my skin myself with various remedies before I found out about Red Skin Syndrome. The TS stopped working for me at age 55 in late September 2010 and my chest and stomach broke out into progressive weird, itchy hives all that would not clear up, even with the steroids. My doctor prescribed oral steroids for me but I did not take them at that point.I surfed the internet and found Dr. Wheatgrass’ forum and emailed him for help. He advised me through his online support group to use small amount of oral steroids and to keep tapering down from them until it cleared, but after a few weeks of that, I realized it only delayed the inevitable.

By this time, of five months into ceasing all topical steroids and trying orals, I was desperate. My body now had all kinds of symptoms going on, spreading rashes, red, hot burning skin over much of it and the classic “red sleeve” on both arms that distigushes Red Skin Syndrome from eczema and other skin diseases.

I ended up surfing the internet once again in total anxiety with the phrase “steroid cream side-effects” and Kelly Palace’s “Addicted Skin” website popped up. I immedieately emailed her and she answered me back the next day, explaining her red skin symptoms and I had that emotional light bulb moment so many of us describe. I joined her small Google support group and learned all about Red Skin Syndrome there and got heavily proactive in the cause to prevent RSS and find ways to treat or cure it.

What made you feel you had RSS? The many symptoms of itchy hives, spreading rashes, hot, burning skin, lumps, freezing cold, sweating, insomnia, nerve zingers, weight loss, eye problems, “elephant” skin, insane itching and flaking… did not match any eczema I’d ever experienced. Once I saw Kelly’s same symptom pics, heard her story along with the others in the support group, I knew I had the same steroid-induced disease as they did.

Were you diagnosed by a doctor? No, my doctor had never heard of steroid-induced anything and was at a loss for what it was. Dr. Rapaport eventually spoke with her on the phone and explained RSS to her and how to keep me comfortable the best she could.

Did you have a supportive doctor? Yes! She went above and beyond to see me when I needed her,  monitor my symptoms, listen to concerns, prescribe comfort meds and check my bloodwork. She felt very bad that this physical trauma had happened to me. She is now supportive of my work with ITSAN and any patient that would come to her with it.

What were your first symptoms? Oddly enough, mine were itchy hives and then spreading rashes. The burning hot skin and red sleeves did not manifest until five months after stopping TS. Some people are what I call “slow burners” like I was.

Was/Is your family supportive? Friends? Yes, my family was very supportive as they had never seen me this sick. It felt like I was going through Chemo treatments, had third degree burns and was literally wasting away. They were scared and stood by me lovingly and immensely. My grandchildren made me get well cards and poems often, which would bring on a river of tears every time  they brought them to me. Friends were not as supportive, simply because they didn’t know what to say or do and I could not visit with anyone very long due to the scratching and living mostly in my bathtub and bedroom for two years.

Have you ever been to a hospital for this? Why? Yes, I was peaking in my worst symptoms in November and December 2011, which was 15 months after stopping TS. I had sever nerve pain all over my body which could have been intensified by the fibromyalgia that I had been diagnosed with in 2000. I had such bad nerve pain and was so red and frail that I could not function anymore and thought I had sepsis.   I went to the ER and the doctor said I did not have sepsis and wanted to prescribe oral steroid for me. I refused and he walked out of the room and said he could not help me then.

Two weeks later I went into another local hospital ER with extreme nerve pain, burning and fatigue, still. This doctor was a lady who believed me and she gave me an IV of pain meds, sedative and stomach buffers. I ended up using those meds and others often for the next 15 months as my journey was hard.

What was the hardest part of this disease? The 24-7 nerve pain and bone deep itching that lasted way too long.

How long did RSS last for you? A total of 62 months but the worst phase was for 27 months. About 98 per cent of my skin healed after 27 months but it took another 35 months of very slow, almost stagnant healing on that last 2% of my skin to heal.

What did you use as comfort measures during this time? Prayer, keeping hope and releasing my tears often. Hot Epsom salt baths about six times a day, heating pad or hot water bottle, white palm oil, vinyl gloves on my hands and various meds.

Are you employed? Fortunately, I was not employed as the fibromyalgia I was diagnosed with and a ruptured disc in my back had taken me out of the physical work force years prior.  I spent all my time when not in the bathtub, helping others in the support group.

Have you gone to therapy or wish you had? I have been to therapy before due to past trauma in my life resulting in PTSD so I utilized all of my counseling “tools” and did the best to keep myself sane and hopeful. The support groups were a lot of therapy for me and that is why I started a couple more.  I now go to physical therapy once a month for osteoarthritis, fibromyalgia and chronic joint and bone problems, which I strongly suspect were helped along by the steroids. My hope is that my body is still healing on the inside as well as my skin did.

If there is one thing you could say to another sufferer, what would it be? You are not alone. Take this one hour at a time and don’t set a time for your recovery, it’s too discouraging when it does not end when you think it should. Keep hope in your mind and heart for healing, even if it’s not the total healing you desire. This is not a lifetime disease, many RSS vets have come through this recovered and gone on with their lives.  It’s not what happens to us in life but how we respond. This suffering can make you a better, more compassionate person if you allow it.  Become proactive to help get RSS known and prevented. Share your story, encourage others and stay positive. This will pass!


Thank you Joey for such a great interview!

Different Instructions for the Same Steroid

If things weren’t confusing or muddled enough, it has come to my attention that a steroid can have different recommendations in different countries. The steroid is the same and yet guidelines are blatantly different.

Let’s take Diprosone for example. This is a Betamethasone Dipropionate topical steroid.

In the UK, it states:

  • Do not use on any other skin problem as it could make it worse especially rosacea (a skin condition affecting the face), acne, dermatitis (skin inflammation) around the mouth, genital itching, nappy rash, cold sores, chickenpox, shingles or other skin infections. Ask your doctor or pharmacist if you are not sure.
  • Talk to your doctor or pharmacist before using diprosone ointment. This medicine should not be used under bandages or plasters.
  • Side effects that may happen with oral or injectables corticosteroids may also occur with corticosteroids used on the skin, especially in infants and children.
  • If the ointment is used more often than it should, or more than prescribed, it can affect some of your child’s hormones. This may affect their growth and development.
  • If Diprosone Ointment is used in children, it should not be used on any part of their body for more than 5 days.
  • Do not put the ointment under your child’s nappy, as this makes it easier for the active ingredient of the medicine to pass through the skin and possibly cause some unwanted effects.
  • Usually for adults and children, a thin layer of Diprosone Ointment should be rubbed into the affected area of skin twice a day.
  • Do not use the ointment on your face for more than 5 days.
  • Do not use a large amount of ointment on large areas of the body, open wounds or areas of the body where joints bend for a long time (for example every day for many weeks or months).
  • Most people find that when the ointment is used correctly, it does not cause any problems. However, if you use the ointment more than you should, particularly on your face, it can cause redness, stinging, blistering, peeling, swelling, itching, burning, skin rash, dryness of the skin, in the skin, inflammation of the hair follicles; excessive hair growth, reduced skin pigmentation; allergic skin reactions; dermatitis (skin inflammation); other skin infections, thinning of the skin and red marks.

In Australia, it states:

  • Do not use Diprosone if you have:

a viral skin infection, such as cold sores, shingles or chicken pox, a fungal skin infection, such as thrush, tinea or ringworm, tuberculosis of the skin, acne rosacea, inflammation around the mouth, skin conditions with ulcers,

Unless your doctor tells you.

(^^^^^^^ That seems unbelievably risky).

  • Do not use Diprosone just before having a bath, shower or going swimming.
  • Tell your doctor if: you are pregnant or breast feeding.
    Your doctor will tell you if you can use Diprosone during pregnancy or while you are breast feeding.

(^^^^^ again, whatever your doctor tells you? Why can’t the pamphlet tell me? Or is it that nobody knows and everyone is just guessing…)

  • Apply a thin film of Diprosone Cream or Ointment or a few drops of Diprosone Lotion to the affected skin or scalp twice daily. Massage gently until it disappears. For some patients, once daily application may be enough for maintenance therapy.
  • It is important to use Diprosone exactly as your doctor has told you.

(^^^^^ What if they tell you to go against the guidelines?)

  • Do not use Diprosone for more than four weeks at a time unless your doctor tells you.

(^^^^^^ And here is my point!)

  • Do not use Diprosone under dressings or on large areas of skin unless your doctor tells you

In the UK pamphlet, it says you should not use steroids on an infection site, even though the AU pamphlet says you can do it if your doctor instructs you to do so.

In the UK pamphlet, it says you should not use this steroid under occlusion, yet the AU pamphlet says it is ok if the doctor tells you to do so.

In the UK pamphlet, there doesn’t seem to be a set time recommendation to use the steroid (except for children and for the face), while the AU pamphlet says to use it no longer than 4 weeks unless your doctor says to do so, but doesn’t say how long to use it on the face.

In both pamphlets, it seems to leave pregnant women under the discretion of their doctor or their pharmacist.

Over and over in these pamphlets, there seems to be a lot of “just ask your doctor” or “unless prescribed by your doctor”. What happened to facts? What happened to “these are the guidelines and they need to be adhered to for the patient’s safety”? Moreover, there are doctors who get paid to prescribe certain drugs to patients, so where is the ethical line? Want to check out your doctor? Dollars for Docs

Also, RSS is not a side effect listed. It never is and should be. Red Skin Syndrome is not just a small symptom or side effect that will go away very quickly. This condition affects so much more than just your skin!

Doctors should also be educating their patients about steroid use, the good and the bad, as well as staying up to date with medical findings and research. Even a well meaning doctor can over prescribe this medication so it is pertinent that you know all there is about topical steroids before you begin use.

 

Feature #1: Joanne & Sandy

Joanna Andersonjoanna-anderson

Age: 36

Career: Daycare provider. Forced to close business due to RSS. Unemployed.

When did you cease using topical steroids: April 2015

What type did you use: Clobetasol propionate.

What is your favorite product for comfort? Curel itch defense with ceramide.

What is the hardest thing to deal with during this condition? Having to be alone taking care of my newborn despite the pain.

What is the first thing you will do when healed? When I am healed I will help others in need.


sandy-weindbergSandy Weinberg

Age: 53

Career: Customer service Representative for ReadyRefresh by Nestlé (Nestlé Waters)

When did you cease using topical steroids: I stopped using prednisone the beginning of June  2015

What type did you use: Mainly oral prednisone, also Triamcinolone, Desonide Cream and Clocortolone Pivalate Cream

What is your favorite product for comfort? I have a few favorites: Stephanie’s Home Apothecary Body balms, coconut Oil and Cerave products, also started using Germolene cream…love it!

What is the hardest thing to deal with during this condition? Working out and running. Saying no to going out with friends. Not being able to sit in the sun. Missing a lot of time from my job .

What is the first thing you will do when healed? Possibly run a marathon! Spending more time with family and friends. Just enjoying life! Traveling and meeting some of the others who have gone through like myself.

Medical Terminology Explained

One of the many ways we can feel left out of the medical loop is the jargon that leaves us perplexed and, most likely, uninterested in trying to understand our ailment. The doctor either says some fancy words or we end up reading a pamphlet that looks like ancient hieroglyphics. It can be daunting and when we just want relief, we don’t delve any further than the reaching to take a prescription from the doctor.

The time has come for us to decipher some very important medical terminology so we, as patients, can be best informed about our condition and what may lie ahead if we take a certain treatment.


Antiproliferative: of or relating to a substance used to prevent or retard the spread of cells, especially malignant cells, into surrounding tissues.

Atherosclerosis: a disease in which plaque builds up inside your arteries. This can cause different problems including coronary heart disease, carotid artery disease, and chronic kidney disease.

Atrophy: waste away, typically due to the degeneration of cells, or become vestigial during evolution. Picture

Axillae: Armpit

Bioethics: the study of the typically controversial ethical issues emerging from new situations and possibilities brought about by advances in biology and medicine. It is also moral discernment as it relates to medical policy and practice.

Corticosteroids: any of a group of steroid hormones produced in the adrenal cortex or made synthetically. There are two kinds: glucocorticoids and mineralocorticoids. They have various metabolic functions and some are used to treat inflammation. The ones we usually deal with are glucocorticoids that stop inflammation.

Candidiasis: infection by fungi of the genus Candida, generally C. albicans, most commonlyinvolving the skin, oral mucosa (thrush), respiratory tract, or vagina; occasionally thereis a systemic infection or endocarditis. It is most often associated with pregnancy,glycosuria, diabetes mellitus, or use of antibiotics. Picture

Concomitant: naturally accompanying or associated.

Cutaneous: of, relating to, or affecting the skin.

Demodicidosis: skin disease of the pilosebaceous units associated with human Demodex mites that involves predominantly the face and head. Picture

Edema: a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body. Picture

Efficacy: the ability to produce a desired or intended result.

Emollient: a preparation that softens the skin.

Erythema: superficial reddening of the skin, usually in patches, as a result of injury or irritation causing dilatation of the blood capillaries. Picture

Exacerbation: an increase in the severity of a disease or its signs and symptoms; a worsening.

Granuloma Gluteale Infantum: a rare skin disorder of controversial etiology characterized by oval, reddish purple granulomatous nodules on the gluteal surfaces. Picture

Gynecomastia: enlargement of a man’s breasts, usually due to hormone imbalance or hormone therapy. Picture

Hirsutism: abnormal growth of hair on a person’s face and body, especially on a woman. Picture

HPA axis: The hypothalamic–pituitary–adrenal axis is a complex set of direct influences and feedback interactions among three endocrine glands: the hypothalamus, the pituitary gland(a pea-shaped structure located below the hypothalamus), and the adrenal (also called “suprarenal”) glands (small, conical organs on top of the kidneys).

Hyperkeratosis: thickening of the stratum corneum (the outermost layer of the epidermis, or skin), often associated with the presence of an abnormal quantity of keratin, and also usually accompanied by an increase in the granular layer. Picture

Hyperpigmentation: the darkening of an area of skin or nails caused by increased melanin.

Hypertrichosifs: a skin abnormality that results in excessive growth of hair. It can be localized to one part of the body, or affect in full. It can affect men or women and is mostly secondary to a genetic disease that causes a hormonal disorder. Picture

Hypopigmentation: the loss of skin color. It is caused by melanocyte or melanin depletion, or a decrease in the amino acid tyrosine, which is used by melanocytes to make melanin. Picture

Iatrogenic: of or relating to illness caused by medical examination or treatment.

Immunosuppressive: (chiefly of drugs) partially or completely suppressing the immune response of an individual. Topically, there is Protopic and Elidel.

Impetigo: a contagious bacterial skin infection forming pustules and yellow, crusty sores. Picture

In vivo: (of a process) performed or taking place in a living organism.

Intertriginous: area where two skin areas may touch or rub together, like armpit or groin

Kaposi Sarcoma: a rare tumor that is named after the dermatologist who first described it in 1872. It is caused by a type of herpesvirus. Picture

Lichen Sclerosis: an uncommon condition that creates patchy, white skin that’s thinner than normal. Picture

Malassezia Folliculitis: an inflammatory skin disorder that typically manifests as a pruritic, follicular papulopustular eruption distributed on the upper trunk of young to middle-aged adults. Picture

Mastocytosis: disorder that can occur in both children and adults. It is caused by the presence of too many mast cells in your body. You can find mast cells in skin, lymph nodes, internal organs (such as the liver and spleen) and the linings of the lung, stomach, and intestine. Picture

Milia: a small white or yellowish nodule resembling a millet seed, produced in the skin by the retention of sebaceous secretion. Picture

Molluscum Contagiosum: a chronic viral disorder of the skin characterized by groups of small, smooth, painless pinkish nodules with a central depression, that yield a milky fluid when squeezed. Picture

Morbidity: is a term used to describe how often a disease occurs in a specific area.

Occlusive: Of or being a bandage or dressing that closes a wound and keeps it from the air.

Ocular Hypertension: an eye pressure of greater than 21 mm Hg. It usually occurs for a long time and doesn’t match with glaucoma.

Perioral Dermatitis: a common skin rash that mainly affects young women. The rash affects the skin around the mouth. Use of a steroid cream on the face seems to trigger the condition in many cases. Picture

Phimosis: a congenital narrowing of the opening of the foreskin so that it cannot be retracted.

Purpura: a rash of purple spots on the skin caused by internal bleeding from small blood vessels. Picture

Stellate Pseudoscars: white, irregular or star-shaped atrophic scars occurring over the sun-exposed areas of the forearms. Picture

Stratum Corneum: the horny outer layer of the skin.

Striae: a linear mark, slight ridge, or groove on a surface, often one of a number of similar parallel features. Picture

Synthetic: made by chemical synthesis, especially to imitate a natural product.

Systemic: of, relating to, or affecting the entire body.

Tachyphylaxis: rapidly diminishing response to successive doses of a drug, rendering it less effective. The effect is common with drugs acting on the nervous system.

Telangiectasia: a condition characterized by dilation of the capillaries, which causes them to appear as small red or purple clusters, often spidery in appearance, on the skin or the surface of an organ. Picture

Tinea Incognito: a fungal infection (mycosis) of the skin masked and often exacerbated by application of a topical immunosuppressive agent. The usual agent is a topical corticosteroid (topical steroid). Picture

Vasoconstriction: the constriction of blood vessels, which increases blood pressure.

Vitiligo: a condition in which the pigment is lost from areas of the skin, causing whitish patches, often with no clear cause. Picture