Topical Corticosteroids
Topical Corticosteroids
Topical Corticosteroids
They are potent anti-inflamatory and antipruritic agents. The main indications for use in pediatric practice are : Severe napkin dermatitis, infantile eczema, seborrheic dermatitis and severe itching associated with acute or chronic allergic conditions. They are contraindicated in the following conditions: Viral infection of the skin as chickenpox and herpes simplex, tuberculous or syphilitic skin lesions and cutaneous reactions to vaccination. They are available in several forms. Creams are suitable for acute wet lesions, while Ointments are suitable for chronic dry lesions. For napkin dermatitis, which is mainly wet, creams are the only suitable forms. In general, the application of a thin layer, 2 times daily is sufficient. Duration of therapy should be as short as possible. For acute conditions, 3 5 days treatment is generally sufficient. For prolonged use in chronic conditions, the weak forms (nonflourinated) are preferable to minimize the complications. Side effects of prolonged use are both local and systemic. Skin atrophy, hypopigmentation and telangiectasia may occur. Significant systemic absorption may occur with fluorinated forms and lead to temporary suprarenal suppression.
1 - Nonflourinated preparations
They are suitable for mild to moderate cases and should be the first choice in pediatrics, because the side effects are minimal. Available drugs and preparations are:
Prednicarbate (Dermatop cream and ointment) Aclometasone (Perderm cream and ointment) Hydrocortisone (Hydrocortisone cream and ointment)
2 - flourinated preparations
These powerful forms should be used cautiously and for short periods because of the high incidence of side effects.
1 Flumethasone (Locacorten) 2 Triamcinolone (Topicort) 3 Betamethasone valerate (Betaderm) 4 Betamethasone dipropionate (Diprosone) 5 Mometasone (Elocon) 6 Diflucortolone (Nericide) 7 Halomethasone (Sicorten ) 8 Fluticasone propionate (Cutivate) 9 Clobetasol propionate (Dermovate)