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The use of corticosteroids and corticosteroid phobia in atopic dermatitis

      For more than four decades, topical corticosteroids have formed the mainstay of treatment for atopic dermatitis. Since the synthesis of hydrocortisone in 1951, an increasing number of preparations have been developed, with attention being focused on the development of more powerful compounds with improved bioavailability and reduced risk of side effects.
      • Korting H.C
      • Kerscher M.J
      • Schafer-Korting M
      Topical glucocorticoids with improved benefit-risk ratio do they exist?.
      When used appropriately as part of an integrated management approach, topical corticosteroids can provide a highly effective and safe method for controlling the symptoms of atopic dermatitis and restoring patients’ quality of life.
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      References

        • Korting H.C
        • Kerscher M.J
        • Schafer-Korting M
        Topical glucocorticoids with improved benefit-risk ratio.
        J Am Acad Dermatol. 1992; 27: 87-92
      1. Yohn JJ, Weston WL. Topical glucocorticosteroids. Curr Probl Dermatol 1990;March/April:31–63

        • Charman C.R
        • Morris A.D
        • Williams H.C
        Topical corticosteroid phobia in patients with atopic eczema.
        Br J Dermatol. 2000; 142: 931-936
        • Miller J.A
        • Munro D.D
        Topical corticosteroids.
        Drugs. 1980; 19: 119-134
      2. McKenzie AW, Stoughton RB. Method for comparing percutaneous absorption of steroids. Arch Dermatol 1962;86:608–10.

        • Leung D.Y
        • Hanifin J.M
        • Charlesworth E.N
        • et al.
        Disease management of atopic dermatitis.
        Ann Allergy Asthma Immunol. 1997; 79: 197-211
      3. British National Formulary. London: British Medical Association, Royal Pharmaceutical Society of Great Britain. 2001;42:534

        • Olsen E.A
        • Cornell R.C
        Topical clobetasol-17-propionate.
        J Am Acad Dermatol. 1986; 15: 246-255
        • Hoare C
        • Li Wan Po A
        • Williams H
        Systematic review of treatments of atopic eczema.
        Health Technol Assess. 2000; 4: 1-191
        • Ramsay C.A
        • Savoie J.M
        • Gilbert M
        • et al.
        The treatment of atopic dermatitis with topical fusidic acid and hydrocortisone acetate.
        J Eur Acad Dermatol Venereol. 1996; 7: 15-22
        • Hjorth N
        • Schmidt H
        • Thomsen K
        Fusidic acid plus betamethasone in infected or potentially infected eczema.
        Pharmatherapeutica. 1985; 4: 126-131
        • Wachs G.N
        • Maibach H.I
        Co-operative double-blind trial of an antibiotic/corticoid combination in impetiginized atopic dermatitis.
        Br J Dermatol. 1976; 95: 323-328
        • Hein R
        • Mauch C
        • Hatamochi A
        • Krieg T
        Influence of corticosteroids on chemotactic response and collagen metabolism of human skin fibroblasts.
        Biochem Pharmacol. 1988; 37: 2723-2729
        • Kerscher M.J
        • Hart H
        • Korting H.C
        • et al.
        In vivo assessment of the atrophogenic potency of mometasone furoate, a newly developed chlorinated potent topical glucocorticoid as compared to other topical glucocorticoids old and new.
        Int J Clin Pharmacol Ther. 1995; 33: 187-189
        • Kerscher M.J
        • Korting H.C
        Comparative atrophogenicity potential of medium and highly potent topical glucocorticoids in cream and ointment according to ultrasound analysis.
        Skin Pharmacol. 1992; 5: 77-80
        • Korting H.C
        • Vieluf D
        • Kerscher M
        0.25% Prednicarbate cream and the corresponding vehicle induce less skin atrophy than 0.1% betamethasone-17-valerate cream and 0.05% clobetasol-17-propionate cream.
        Clin Pharmacol. 1992; 42: 159-161
        • Kerscher M.J
        • Korting H.C
        Topical glucocorticoids of the non-fluorinated double-ester type.
        Acta Derm Venereol (Stockh). 1992; 72: 214-216
        • Van der Meer J.B
        • Glazenburg E.J
        • Mulder P.G.H
        • et al.
        The management of moderate to severe atopic dermatitis in adults with topical fluticasone propionate.
        Br J Dermatol. 1999; 140: 1114-1121
        • Thomas K.S
        • Armstrong S
        • Avery A
        • et al.
        Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema.
        Br Med J. 2002; 324(7340): 768
        • Lane A.T
        Efficacy and safety of topical steroids in paediatric atopic dermatitis.
        J Eur Acad Dermatol Venereol. 1997; 8: S24-27
        • West D.P
        • Worobec S
        • Solomon L.M
        Pharmacology and toxicology of infant skin.
        J Invest Dermatol. 1981; 76: 147-150
        • Rasmussen J.E
        Percutaneous absorption of topically applied triacinolone in children.
        Arch Dermatol. 1978; 114: 1165-1167
        • Lucky A.W
        • Grote G.D
        • Williams J.L
        • et al.
        Effect of desonide ointment, 0.05%, on the hypothalamic-pituitary-adrenal axis of children with atopic dermatitis.
        Cutis. 1997; 59: 151-153
        • Vernon H.J
        • Lane A.T
        • Weston W
        Comparison of mometasone furoate 0.1% cream and hydrocortisone 1.0% cream in the treatment of childhood atopic dermatitis.
        J Am Acad Dermatol. 1991; 24: 603-607
        • Marten R.H
        • Byrne J.P.H
        • Peiris S
        • et al.
        Study of the effects of hydrocortisone and hydrocortisone-17 butyrate ointments or plasma ACTH levels and synacthen responses in children with eczema.
        Dermatologica. 1980; 160: 216-269
        • Patel L
        • Clayton P.E
        • Addison G.M
        • et al.
        Adrenal function following topical steroid treatment in children with atopic dermatitis.
        Br J Dermatol. 1995; 132: 950-955
        • Ellison J.A
        • Patel L
        • Ray D.W
        • et al.
        Hypothalamic-pituitary-adrenal function and glucocorticoid sensitivity in atopic dermatitis.
        Pediatrics. 2000; 105: 794-799
        • Weston W.L
        • Sams Jr, W.M
        • Morris H.G
        • et al.
        Morning plasma cortisol levels in infants treated with topical fluorinated glucocorticosteroids.
        Pediatrics. 1980; 65: 103-106
        • Munro D.D
        Topical corticosteroid therapy and its effect on the hypothalamo-pituitary-adrenal axis.
        Dermatologica. 1976; 152: 173-180
        • Queille C
        • Pommarede R
        • Saurat J.-H
        Efficacy versus systemic effects of six topical steroids in the treatment of atopic dermatitis of childhood.
        Pediatr Dermatol. 1984; 1: 246-253
        • Wolkerstorfer A
        • Strobos M.A
        • Glazenburg E.J
        • et al.
        Fluticasone propionate 0.05% cream once daily versus clobetasone butyrate 0.05% cream twice daily in children with atopic dermatitis.
        J Am Acad Dermatol. 1998; 39: 226-231
        • Keipert J.A
        • Kelly R
        Temporary Cushing’s syndrome from percutaneous absorption of betamethasone valerate.
        Med J Aust. 1971; 1: 542-544
        • May P
        • Stein E.J
        • Ryter R.J
        • et al.
        Cushing’s syndrome from percutaneous absorption of triamcinolone cream.
        Arch Intern Med. 1976; 136: 612-613
        • Patel L
        • Clayton P.E
        • Jenney M.E
        • et al.
        Adult height in patients with childhood onset atopic dermatitis.
        Arch Dis Child. 1997; 76: 505-508
        • Curtis J.A
        • Cormode E
        • Laski B
        • et al.
        Endocrine complications of topical and intralesional corticosteroid therapy.
        Pediatr Dermatol. 1984; 1: 226-235
        • Hogan D.J
        • Sibley J.T
        • Lane P.R
        Avascular necrosis of the hips following long-term use of clobetasol propionate.
        J Am Acad Dermatol. 1986; 14: 515-517
        • Charman C.R
        • Williams H.C
        Dermatologists’ perceived safety of topical corticosteroids in children with atopic eczema.
        Br J Dermatol. 2001; 145 (Abstract): 127-128
        • Tofte S.J
        • Hanifin J.M
        Current management and therapy of atopic dermatitis.
        J Am Acad Dermatol. 2001; 44: S13-16
        • Clement M
        • Phillips S.H
        • Du Vivier A
        Is steroid tachyphylaxis preventable?.
        Clin Exp Dermatol. 1985; 10: 22-29
      4. Furue M, Terao H, Takeshita H, et al. Topical corticosteroids in the daily management of atopic dermatitis. In: National eczema association proceedings of the international symposium on atopic dermatitis. Portland, Oregon, September 6–9, 2001, p. 23

        • Hauk P.J
        • Hamid Q.A
        • Chrousos G.P
        • Leung D.Y
        Induction of corticosteroid insensitivity in human PBMCs by microbial superantigens.
        J Allergy Clin Immunol. 2000; 105: 782-787
        • Correale C.E
        • Walker C
        • Murphy L
        • Craig T.J
        Atopic dermatitis.
        Am Fam Physician. 1999; 60: 1191-1210
        • McHenry P.M
        • Williams H.C
        • Bingham E.A
        Management of atopic eczema.
        BMJ. 1995; 310: 843-847
        • Feldman R.J
        • Maibach H.I
        Regional variation in percutaneous penetration of 14C cortisol in man.
        J Invest Dermatol. 1967; 48: 181-183
        • Aggarwal R.K
        • Potamitis T
        • Chong N.H.V
        • et al.
        Extensive visual loss with topical facial steroids.
        Eye. 1993; 7: 664-666
        • Cubey R.B
        Glaucoma following the application of topical steroid to the skin of the eyelids.
        Br J Dermatol. 1976; 95: 207-208
        • Howell J.B
        Eye diseases induced by topically applied steroids.
        Arch Dermatol. 1976; 112: 1529-1530
        • Wilson F.M
        Adverse external ocular effects of topical ophthalmic medications.
        Surv Opthalmol. 1979; 24: 57-88
        • Williams H.C
        Do topical steroids reduce relapses in adults with atopic dermatitis?.
        Arch Dermatol. 1999; 135: 1530-1531
        • Faergemann J
        • Christensen O
        • Sjövall P
        • et al.
        An open study of efficacy and safety of long-term treatment with mometasone furoate fatty cream in the treatment of adult patients with atopic dermatitis.
        J Eur Acad Dermatol Venereol. 2000; 14: 393-396
        • Emerson R.M
        • Williams H.C
        • Allen B.R
        Severity distribution of atopic dermatitis in the community and its relationship to secondary referral.
        Br J Dermatol. 1998; 139: 73-76
        • Atherton D.J
        Skin diseases in the young.
        Res Clin Forums. 1985; 5: 83-86
        • Wolkerstorfer A
        • Visser R.L
        • De Waard van der Spek F.B
        • et al.
        Efficacy and safety of wet-wrap dressings in children with severe atopic dermatitis: influence of corticosteroid dilution.
        Br J Dermatol. 2000; 143: 999-1004
        • Pei A.Y.S
        • Chan H.H.L
        • Ho K.M
        The effectiveness of wet wrap dressings using 0.1% mometasone furoate and 0.005% fluticasone propionate ointments in the treatment of moderate to severe atopic dermatitis in children.
        Ped Dermatol. 2001; 18: 343-348
      5. Smitt S, Spuls Ph, Van Leent EJM, et al. Randomized double blind comparison of continuous versus pulsed topical treatment with clobetasone butyrate in 40 children with atopic dermatitis. In: National eczema association proceedings of the international symposium on atopic dermatitis. Portland, Oregon, September 6–9, 2001, p. 24

        • Koopmans B
        • Lasthein Andersen B
        • Mork N.J
        • et al.
        Multicentre randomized double-blind study of Locoid Lipocream fatty cream twice daily versus Locoid Lipocream once daily and loco-base once daily.
        J Dermatol Treat. 1995; 6: 103-106
        • Sudilovsky A
        • Muir J.G
        • Bocobo F.C
        A comparison of single and multiple applications of halcinonide cream.
        Int J Dermatol. 1981; 20: 609-613
        • Bleehan S.S
        • Chu A.C
        • Hamann I
        • et al.
        Fluticasone propionate 0.05% cream in the treatment of atopic eczema.
        Br J Dermatol. 1995; 133: 592-597
        • Lagos B.R
        • Maibach H.I
        Frequency of application of topical corticosteroids.
        Br J Dermatol. 1998; 139: 763-766
        • Tharp M
        Comparison of twice daily and once daily administration of fluticasone propionate cream 0.05% in the treatment of eczema.
        Cutis. 1996; 57: 19-26
        • Lebwohl M
        A comparison of once-daily application of mometasone furoate 0.1% cream compared with twice-daily hydrocortisone valerate 0.2% cream in pediatric atopic dermatitis patients who failed to respond to hydrocortisone.
        Int J Dermatol. 1999; 38: 604-606
        • Rafanelli A
        • Rafanelli S
        • Stanganelli I
        • Marchesi E
        Mometasone furoate in the treatment of atopic dermatitis in children.
        J Eur Acad Dermatol Venereol. 1993; 2: 225-230
        • Rajka G
        • Avrach W
        • Gartner L
        • et al.
        Mometasone furoate 0.1% fatty cream once daily versus betamethasone valerate 0.1% cream twice daily in the treatment of patients with atopic and allergic contact dermatitis.
        Curr Ther Res Clin Exp. 1993; 54: 23-29
        • Clement M
        • du Vivier A
        Concern about the current clinical practice of diluting topical glucocorticoid preparations.
        Clin Exp Derm. 1984; 9: 286-289
        • Deeks T
        Compounding and dilution of topical steroids.
        Br J Pharmaceut Pract. 1985; : 134-140
        • Graham-Brown R
        Managing adults with atopic dermatitis.
        Dermatol Clin. 1996; 14: 531-537
        • David T.J
        Steroid scare.
        Arch Dis Child. 1987; 62: 876-878
        • Charman C.R
        • Morris A.D
        • Williams H.C
        Topical corticosteroid phobia in patients with atopic eczema.
        Br J Dermatol. 2000; 142: 931-936
        • Fukaya M
        Why do patients with atopic dermatitis refuse to apply topical corticosteroids.
        Dermatology. 2000; 201: 242-245
        • Ohya Y
        • Williams H
        • Steptoe A
        • et al.
        Psychosocial factors and adherence to treatment advice in childhood atopic dermatitis.
        J Invest Dermatol. 2001; 117: 852-857
        • Long C.C
        • Finlay A.Y
        The fingertip unit.
        Clin Exp Dermatol. 1991; 16: 444-447