Evaluation of the Atrophogenic Potential of Topical Corticosteroids in Pediatric Dermatology Patients

Abstract

We conducted a cross-sectional observational study to determine the atrophogenic potential of TCS in children with dermatitis requiring long-term TCS suppression. Children who were able to achieve good disease control, with a maximum Eczema Area and Severity Index score of 1.0, using TCS were examined for adverse effects of treatment. Cutaneous atrophy was assessed using a validated dermoscopic technique. Cutaneous sites exposed to TCS were compared with nonexposed sites in all patients. There was no significant atrophy in 70 TCS-exposed and 22 TCS-naïve children. Mild grade 1 telangiectasia of the cubital fossa was observed in 3.3% of the test group and 3.1% of the control group (p > 0.99). We conclude that routine, appropriate, long-term use of TCS in children with dermatitis does not cause skin atrophy. These data do not support the widely held belief that routine use of TCS will "thin the skin." Parents, pharmacists, and health practitioners should be confident about the safety of using this treatment.

Pharmacists' knowledge about use of topical corticosteroids in atopic dermatitis: Pre and post continuing professional development education

“…All attendees at the conference were able to attend an evidence-based education session conducted by a paediatric dermatologist presenting data on TCS safety and TCS phobias, previously published in peer-reviewed journals. 7,12,13 Pre and post-education session assessments were performed with responses recorded on an electronic keypad in real time. The questions were developed with the assistance of a psychologist (author AB) and were piloted with pharmacists prior to the session.…”

Topical Corticosteroid Concerns in Dermatological Outpatients: A Cross-Sectional and Interventional Study

“…atrophy, discoloration, hypertrichosis, and systemic effects) [16] or personal ‘bad experience' for any reason. However, TCC is mostly driven by irrational aspects, misconceptions of TCS, ideological orientation, and negative reports by relatives, friends, and media [1,4,5,9,21]. In addition to patient factors, there are also clinician factors in the context of TCC.…”

Atopic Dermatitis: Early Treatment in Children

“…Sustained, long-term use of a mid-potency TCS with one to twice weekly application did not demonstrate adverse effects in a clinical trial [65], and one systematic review concluded a good overall safety profile of TCS [66]. A recent cross-sectional observational study of children with AD on long-term TCS (weak, moderate, and potent) showed no rates of skin atrophy, both in the TCS treatment group and in the control group [67]. Nonetheless, allaying parental fears of TCS use in children is essential in maintaining adherence and appropriate use, which decreases the risks of adverse effects and relapse [68, 69].…”