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Corticosteroids should not be used long term because of adverse effects, the most serious being suppression of the pituitary-adrenal axis. Newer drugs are cytokine inhibitors and monoclonal cytotec to purchases. These are reserved for severe active rheumatic disease (but not systemic lupus erythematosus) that is unresponsive to other drugs and must only be used under close medical supervision. Gout is an inflammatory joint disease caused by deposition of uric acid crystals in the joints. Treatment of gout aims to control acute attacks with analgesics and colchicine and in the longer term to reduce circulating uric acid levels either by inhibiting its production with allopurinol or by encouraging its excretion by the kidneys with probenecid or sulfinpyrazone. Osteoarthritis is primarily a degenerative joint disease, but as joint destruction occurs this creates local inflammation.

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Tolnaftate is not available on prescription, but it can be bought over the counter as a cream. In some patients, it may produce skin reactions such as irritation, puritis or allergic contact dermatitis.

  • However, other types of laxatives are better for this purpose.
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Local anaesthetics can affect both autonomic nerves and the neuromuscular junction. Apart from their local anaesthetic action, local anaesthetics have anticholinergic activity.

Malfunction of these areas is implicated in disorders such as Parkinsons disease and schizophrenia. The cerebrum is highly developed in humans. The cerebral cortex is a layer of neurons about activities take place. Sensory information coming into the cerebrum is interpreted by specific areas of the cortex. Movement of body parts is controlled by another area of the cortex.

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Eczema is inflammation of the epidermis and is best managed by avoiding the cause, if known. Mild eczema can be treated with emollients if dry, or astringents if wet. Topical corticosteroids are effective in most cases of persistent eczema. With very severe resistant eczema, immunosuppressant drugs may be needed. Psoriasis is a chronic inflammatory skin disease with hyperproliferation of keratinocytes, which leads to thickening of the epidermis and typical silvery scales on the surface. Topical treatments include drugs that reduce cell division, such as calcipotriol, dithranol and coal tar, and keratolytics and emollients.


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Other more specialized treatments are cryotherapy, using liquid nitrogen, electrosurgery, surgical excision, bleomycin injections and carbon dioxide laser. Fungal infection of the skin and nails will be familiar to podiatrists.

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