From the Research
Management of exfoliative dermatitis potentially related to Wegovy (semaglutide) should begin with immediate discontinuation of the medication and prompt dermatology consultation. The approach to treatment should include discontinuation of any potentially causative medications and a search for any underlying malignancy 1.
Key Considerations
- Discontinuation of the offending medication is crucial to prevent further exacerbation of the condition.
- Topical corticosteroids such as triamcinolone 0.1% or clobetasol 0.05% applied twice daily to affected areas, along with oral antihistamines like cetirizine 10mg daily or hydroxyzine 25mg every 6 hours as needed for itching, can be used as first-line treatment.
- For severe cases, a short course of systemic corticosteroids may be necessary, typically prednisone 0.5-1mg/kg/day for 1-2 weeks with a gradual taper, as suggested by experts in the field of dermatology 2.
- Supportive care is essential and includes maintaining skin hydration with frequent application of emollients like petroleum jelly or ceramide-containing moisturizers, avoiding hot showers, wearing loose cotton clothing, and ensuring adequate fluid intake to prevent dehydration.
- Patients should be monitored for complications such as secondary infections, electrolyte imbalances, and thermoregulatory disturbances.
Additional Recommendations
- A systematic review of the safety and efficacy of systemic corticosteroids in atopic dermatitis suggests that their use should be limited to short courses as a bridge to steroid-sparing therapies 3.
- The use of systemic corticosteroids can be associated with several side effects, including growth suppression in children, osteoporosis, and adrenal insufficiency, among others 3.
- After resolution, alternative weight management strategies should be discussed, as rechallenge with semaglutide is generally not recommended following a severe cutaneous adverse reaction.
- Contact dermatitis, which can be a differential diagnosis for exfoliative dermatitis, can be managed by avoiding the suspected irritants or allergens, restoring the skin barrier, and reducing skin inflammation through multiple treatments, such as emollients, topical corticosteroids, and antihistamines 4.