Intermittent Tetracosactrtn-Depot Therapy in Dermatology

Abstract

Experience with tetracosactrin-depot therapy in 10 patients with dermatological disorders is described. The clinical response was considered good in 7 patients, poor in the remaining 3. Plasma cortisol levels remained elevated 24 to 48 hr. following injection but there were considerable differences between patients in both the magnitude and duration of response.Melanoderma and other side efFects were troublesome when the total weekly dose exceeded 1 mg. Smaller dosages gave satisfactory response without significant accompanying side effects.

Managing atopic dermatitis with systemic therapies in adults and adolescents: An Australian/New Zealand narrative

“…12 Whilst there are no quality studies of oral corticosteroid use for the management of atopic dermatitis, [13][14][15][16][17] they are widely prescribed, with a high satisfaction rating by patients. 7,18 Similarly, the studies of intramuscular triamcinolone, 19,20 intravenous methylprednisolone 21 or subcutaneous ACTH depot 22,23 are all of low quality, although they do indicate short-term response. A 4-week study in 26 children with severe atopic dermatitis compared combined oral and nasal beclomethasone dipropionate (1200 lg/day) to placebo.…”

Drug induced changes in pigmentation

“…The hypermelanosis was reversed by reduction of the dose of ACTH and by the administration of dexamethasone. Khan & Smith (1970) found an apparently higher incidence of hypermelanosis with the use of the synthetic compound tetracosactrin, ORAL CONTRACEPTIVES All oral contraceptives may produce chloasma, particularly in women who have developed such pigmentation in pregnancy. The incidence of chloasma increases with the length of time that the oral contraceptive is taken, Rice-Wray et al (1962) found a high incidence of chloasma in Mexican women receiving the oral contraceptive.…”

Notable Advances in the Treatment of Skin Diseases 1946‐1970

“…Although systemic steroids may be required to control severe atopic dermatitis there is an important place for ACTH here, and for exacerbations of atopic eczema. Both Verbov (1968, 1970) and Khan and Smith (1970) have described the use of a long‐acting synthetic corticotrophin, tetracosactrin‐depot (‘Synacthen’ depot) in dermatology. Patients with atopic dermatitis should normally not have smallpox vaccination or be exposed to anyone with a fresh vaccination or herpes simplex infection.…”