Saraswat Abir
Indushree Skin Clinic, Lucknow, Uttar Pradesh, India.
Indian J Dermatol. 2014 Sep;59(5):469-72. doi: 10.4103/0019-5154.139877.
Dermatologists rely very heavily on corticosteroids for treating many common dermatoses. Concerns about their incorrect use are widely expressed both in lay public and specialist discourse. From the point of view of medical ethics, issues of autonomy, beneficence and non-maleficence are all raised frequently when we prescribe topical corticosteroids to our patients. We need to be aware of situations when conflicts between these issues arise and have a clear thought process about resolving them. This can only be achieved if we have a thorough understanding of the skin disease being treated coupled with expertise in the use of the varied potencies and available dosage forms of topical corticosteroids. A good understanding of human psychology and effective communication is also needed to use these agents optimally.
皮肤科医生在治疗许多常见皮肤病时非常依赖皮质类固醇。无论是在普通大众还是专业领域的讨论中,对其不当使用的担忧都广泛存在。从医学伦理学的角度来看,当我们为患者开具外用皮质类固醇时,自主性、有益性和不伤害性等问题都会经常出现。我们需要意识到这些问题之间何时会产生冲突,并对解决这些冲突有清晰的思考过程。只有在我们对所治疗的皮肤病有透彻的了解,同时具备使用不同效力和剂型的外用皮质类固醇的专业知识时,才能做到这一点。为了最佳地使用这些药物,还需要对人类心理学有良好的理解和有效的沟通。