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Crisis situations upset the theoretical therapeutic strategy, which ranges from topical treatments to systemic treatments, and from treatments with the fewest side effects to treatments with potentially more serious side effects.

It is all about facing up to an urgent request on the part of the patient: holidays, wedding etc. It is about facing up to the stark psychological suffering by a patient whose relationship with his chronic illness swings back and forth. In a patient whose treatment is well balanced, it is about facing up to an abrupt attack of the disease, triggered by an external event: stress, contact eczema, toxidermia, etc., and that will always need to be tracked down and identified. Of the systemic treatments, topical corticosteroids are the best crisis therapy known to date, being fully well aware that once topical corticotherapy has been started, it will be necessary to devote some thought to its relay, and to the means of avoiding a rebound or a self-perpetuation of the disease. Among the general treatments, phototherapy or PUVA therapy are excellent crisis therapies, when usable. Cyclosporine is also an excellent crisis treatment. Methotrexate acts more slowly and retinoids far more slowly.

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