dexamethasone valerate + hydrocortisone butyrate + hydroxyzine + ketotifen

This is a combination drug containing four active ingredients: - **Dexamethasone valerate** and **hydrocortisone butyrate** are synthetic corticosteroids with anti-inflammatory, immunosuppressive, and antipruritic properties. They act by binding to the glucocorticoid receptor, inhibiting pro-inflammatory signals and promoting anti-inflammatory gene expression. These agents are commonly used for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses[1][3]. - **Hydroxyzine** is a first-generation antihistamine (H1 receptor antagonist) with sedative, anxiolytic, antipruritic, and anticholinergic effects. It is used to treat allergic conditions such as urticaria or pruritus. - **Ketotifen** is an antihistamine with mast cell stabilizing properties; it blocks H1 receptors and inhibits the release of mediators from mast cells. It is primarily used in allergic conditions including atopic dermatitis or chronic urticaria. This combination would be expected to provide broad symptomatic relief for severe inflammatory skin disorders associated with significant itching/allergy components.