Problem
• 21 month old Kyle is present with worsening dry skin patches, especially knees, wrists and elbows. Kyle's mother had been using Cetaphil cream after bathing without results. Recently, OTC hydrocortisone was recommended to patches of dry skin on arms and legs and mother reports failed improvement using OTC hydrocortisone after one week of routine use. Which of the following is the most appropriate next step for topical treatment? Explain your reason for selection and why other treatments were not selected.
• Continue OTC hydrocortisone for 5 more days
• Prescribe hydrocortisone valerate 0.2% (Westcort) cream
• Prescribe hydrocortisone valerate 0.2% (Westcort) ointment
• Prescribe desonide 0.05% (Desonate gel) or (Desowen) cream.