Final answer:
Hydrocortisone must be administered before thyroxine in the management of myxedema coma to prevent adrenal crisis. While hydrocortisone cream reduces symptoms like itching and rashes, it does not address the underlying cause of skin conditions.
Step-by-step explanation:
The question pertains to the management of myxedema coma, a severe form of hypothyroidism. In such cases, the administration of hydrocortisone is essential before initiating thyroxine therapy. Hydrocortisone is given first because it addresses potential adrenal insufficiency that can be life-threatening when starting thyroid hormone replacement in these patients. If thyroxine is administered before hydrocortisone, there is a risk of precipitating an adrenal crisis in patients with underlying adrenal insufficiency. Regarding the Clinical Focus text provided, it should be noted that while the corticosteroid cream containing hydrocortisone can effectively alleviate the symptoms such as itching and rashes by suppressing the immune response and inflammation in the skin, it does not treat the underlying cause of Penny's rash. It provides symptomatic relief by reducing histamine release and subsequent inflammation.