Topical steroid therapy in atopic dermatitis in theory and practice

Abstract

IntroductionTopical glucocorticosteroids (GCSs) are commonly used in treatment of atopic dermatitis (AD).AimTo assess the patients’ compliance with the recommended instructions of the therapy.Material and methodsThe study involved 141 adult AD patients. The clinical course of AD and its treatment with GCSs during the last year were analysed.ResultsIn the periods of exacerbation the lesions involved 10–50% of the skin surface area. Outpatient treatment in specialised dermatological and/or allergology clinics was given to 93% of the study subjects. Sixty-five out of 141 patients regularly attended medical control examinations. Glucocorticosteroids, mostly very potent ones (70.2%), were applied to all the subjects. 66.7% of patients obtained no information about their medications’ anti-inflammatory potential. The substances were applied more frequently than twice daily by 36.4% of the patients. Seventy-two of 141 subjects applied GCSs both temporarily and in the long-term treatment, for 8.3 weeks on average. In the long-term treatment, in which very potent GCSs predominated (70.7%), no one used intermittent therapy. One hundred and thirty patients introduced their own modifications to the instructions concerning GCSs use, among which 37.7% changed the site of application, 58.5% prolonged the duration of application and 49.5% shortened it or occasionally temporarily withdrew the prescribed drug. None of the patients knew the fingertip unit method of dose assessment. Apart from steroid therapy, 56.7% of the patients carried out regular care treatment.ConclusionsThe AD patients need to be thoroughly educated by the medical staff in the topical GCSs therapy in atopic dermatitis.

Soshiho-Tang, a Traditional Herbal Medicine, Alleviates Atopic Dermatitis Symptoms via Regulation of Inflammatory Mediators

“…As a standard therapy for the treatment of AD, topical or systemic steroids and antihistamines are administered in combination with immunosuppressive agents and antibiotics (Schäkel et al, 2014). However, these long-term remedies are not effective in many AD patients due to severe side effects, such as tolerability, metabolic abnormalities, increased infection, and endocrine abnormalities (Jeziorkowska et al, 2015). Therefore, it is necessary to find new, effective therapies with fewer side effects for the treatment of AD.…”

Ginsenoside Rh2 Ameliorates Atopic Dermatitis in NC/Nga Mice by Suppressing NF-kappaB-Mediated Thymic Stromal Lymphopoietin Expression and T Helper Type 2 Differentiation

“…As illustrated in Figure 1a, C-K, F2, G75, PPD, PPT, Rg3, and Rh2 significantly inhibited the production of TSLP in response to TNF-α and Poly I:C. Furthermore, C-K, PPD, Rc, and Rh2 markedly decreased the levels of IL-8 compared with stimulated cells. The ginsenoside Rh2 exhibited the most potent inhibitory effects against the production of both TSLP and IL-8 in similar levels to dexamethasone (DEX), which is widely used in the treatment of AD [26] ( Figure 1A-C). Rh2 was thus chosen as the candidate for subsequent experiments.…”

Effects of glucocorticoids on the skin

“…The risk of adverse effects is also linked to the chemical structure of GCs, and the excipient used in the formulation. The most potent absorption can be achieved with ointments (27) . Hypercortisolism leads to a number of changes in appearance and skin complications.…”