Skin Thickness in Children Treated With Daily or Periodical Inhaled Budesonide for Mild Persistent Asthma. The Helsinki Early Intervention Childhood Asthma Study

Abstract

ABSTRACT:In adults, asthma treatment with high doses of inhaled corticosteroids has resulted in dermal thinning. The aim of this study was to investigate the skin thickness in children with asthma during budesonide treatment. In a double-blind study, 113 children, 5-10 y old, with persistent asthma received budesonide 400 g twice daily for 1 mo and thereafter 200 g twice daily for 5 mo. Thereafter, 56 children received 100 g twice daily for 1 y, whereas 57 other children used budesonide periodically for exacerbations. An additional 54 children were treated with disodium cromoglycate (DSCG) for 18 mo. Skin thickness was measured on each forearm before and after treatment for 6, 12, and 18 mo using a 20-MHz high-resolution ultrasonic device. The initial 6-mo budesonide treatment resulted in a greater reduction in mean skin thickness in the forearms compared with DSCG (right: Ϫ35.9 versus Ϫ5.9 m; p ϭ 0.004; left: Ϫ30.6 versus Ϫ7.3 m; p ϭ 0.03). At month 18, the inter-group differences were no longer significant. Budesonide inhalations in daily doses of 400 -800 g in prepubertal children with newly detected asthma may cause minor dermal thinning. The changes were reversible during low dose or periodic treatment with budesonide. (Pediatr Res 67: 221-225, 2010)

An update on paediatric asthma

“…This study suggests that rescue therapy with ICS during tapering may be a beneficial strategy, and adds to the evidence that ICS at the time of viral infections may be beneficial in children with asthma. This study agrees with the Finnish data which suggests that intermittent ICS may be as effective, and with fewer side-effects, than continuous ICS in children with mild asthma [134][135][136].…”

The science of dermocosmetics and its role in dermatology

“…Tissue thickness (epiderm, dermis, hypodermis), atrophy, acanthosis Tissue turnover, exfoliative process (keratolytics), sunburn (oedema), skin ageing, sensitive skin, cellulitis [69][70][71] Steroid therapy, psoriasis, contact dermatitis, antiinflammatory [82][83][84] Physical properties (torquemeter, cutometer, indentometer)…”

Continuous versus intermittent inhaled corticosteroid (budesonide) for mild persistent asthma in children—not too much, not too little: Figure 1

“…Thus, daily doses of 400 to 800 μg budesonide in prepubertal children may cause minor dermal thinning. The changes were reversible during continuous low-dose or periodic treatment 13. In adults, long-term treatment with glucocorticoids may result in posterior subcapsular cataracts and glaucoma.…”