Side-effects of topical steroids: A long overdue revisit

Coondoo, Arijit; Phiske, Meghana; Verma, Shyam; Lahiri, Koushik

doi:10.4103/2229-5178.142483

Cited by 280 publications

(232 citation statements)

References 8 publications

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“…However, prolonged use of corticoids can lead to the emergence of resistance to the immunosuppressive effects of corticosteroids induced by S. aureus itself. Moreover, the cutaneous side effects of corticosteroids are numerous, including atrophy of the skin, telangiectasias and skin pigment changes among others (Coondoo et al, 2014). Therefore, a topical non-steroidal preparation containing SIO could be of great interest, as a maintenance therapy in conjunction with topical corticosteroids for acute flares.…”

Section: Discussionmentioning

confidence: 99%

Sacha Inchi Oil (Plukenetia volubilis L.), effect on adherence of Staphylococus aureus to human skin explant and keratinocytes in vitro

González-Aspajo¹,

Belkhelfa

Haddioui-Hbabi

et al. 2015

Journal of Ethnopharmacology

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Section: Discussionmentioning

confidence: 99%

Sacha Inchi Oil (Plukenetia volubilis L.), effect on adherence of Staphylococus aureus to human skin explant and keratinocytes in vitro

González-Aspajo¹,

Belkhelfa

Haddioui-Hbabi

et al. 2015

Journal of Ethnopharmacology

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“…Cutaneous atrophy, one of the most challenging local side effects associated with glucocorticoids, is characterized by a reduction in the viable epidermis and stratum corneum (SC) thickness, decreased number of keratinocytes, changes in the organization of collagen and elastin fibers, elimination of fatty tissue, and loss of mast cells [11,12]. Yet, the degree of this adverse event observed in patients is directly related to factors like skin site ("thicker" on scalp or forearm vs. "thinner" on eyelid ), age, potency, and use of occlusion [13]. A way to minimize the risk of developing this adverse event would be to limit exposure of the skin to high concentrations by releasing the drug in a controlled manner.…”

Section: Introductionmentioning

confidence: 99%

Nanocarriers for optimizing the balance between interfollicular permeation and follicular uptake of topically applied clobetasol to minimize adverse effects

Mathes

Melero

Conrad

et al. 2016

Journal of Controlled Release

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The treatment of various hair disorders has become a central focus of good dermatologic patient care as it affects men and women all over the world. For many inflammatory-based scalp diseases, glucocorticoids are an essential part of treatment, even though they are known to cause systemic as well as local adverse effects when applied topically. Therefore, efficient targeting and avoidance of these side effects are of utmost importance. Optimizing the balance between drug release, interfollicular permeation, and follicular uptake may allow minimizing these adverse events and simultaneously improve drug delivery, given that one succeeds in targeting a sustained release formulation to the hair follicle. To test this hypothesis, three types of polymeric nanocarriers (nanospheres, nanocapsules, lipid-core nanocapsules) for the potent glucocorticoid Clobetasol propionate (CP) were prepared. They all exhibited a sustained release of drug, as was desired. The particles were formulated as a dispersion and hydrogel and (partially) labeled with Rhodamin B for quantification purposes. Follicular uptake was investigated using the Differential Stripping method and was found highest for nanocapsules in dispersion after application of massage. Moreover, the active ingredient (CP) as well as the nanocarrier (Rhodamin B labeled polymer) recovered in the hair follicle were measured simultaneously, revealing an equivalent uptake of both. In contrast, only negligible amounts of CP could be detected in the hair follicle when applied as free drug in solution or hydrogel, regardless of any massage. Skin permeation experiments using heat-separated human epidermis mounted in Franz Diffusion cells revealed equivalent reduced transdermal permeability for all nanocarriers in comparison to application of the free drug. Combining these results, nanocapsules formulated as an aqueous dispersion and applied by massage appeared to be a good candidate to maximize follicular targeting and minimize drug penetration into the interfollicular epidermis. We conclude that such nanotechnology-based formulations provide a viable strategy for more efficient -2-drug delivery to the hair follicle. Moreover, they present a way to minimize adverse effects of potent glucocorticoids by releasing the drug in a controlled manner and simultaneously decreasing interfollicular permeation, offering an advantage over conventional formulations for inflammatorybased skin/scalp diseases. Graphical Abstract AbbreviationsAA: Alopecia areata ANOVA: Analysis of variance CCT: capric/caprylic triglyceride CP: Clobetasol propionate

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“…Application of topical corticosteroids to the face and genitalia requires proper application instruction, patient understanding, and a high level of caution. Skin atrophy, striae, dermatitis, acne, purpura, hypertrichosis, delayed wound healing, and dyspigmentation may develop, and exacerbation of infections are seen less frequently 15 . In our case, a daily skin examination was performed by the dermatology team while the patient was on the inpatient medical floor.…”

Section: Discussionmentioning

confidence: 92%