Safety and efficacy of one week oral steroid therapy in the treatment of common eczemas with emphasis on its effect on hypothalamic pituitary adrenal axis: An open label randomized controlled pilot study

Abstract

Introduction: Oral steroids are not commonly used because of fear of side effects. A study was conducted to find out if a short course of 1 week of oral steroid without tapering is effective and safe for the treatment of common eczemas. Materials and Methods: Patients with common eczemas were included in the study. There were five groups. One group each received tablet prednisolone 15 mg morning and 10 mg after dinner for 7 days, tablet methylprednisolone 16 mg morning and 8 mg night for 7 days, and tablet betamethasone 2 mg morning and 1 mg night for 7 days. One group received tablet betamethasone 3 mg once a day as a single morning dose for 7 days and the last group received tablet deflazacort 18 mg morning and 12 mg night for 7 days only. All the patients also received topical clobetasol propionate cream for 1 month. However, the maximum permissible amount of topical clobetasol propionate was 30 g in a month. Basal serum cortisol at 8 am along with ACTH stimulation test was carried out in all the patients on day 10th. The tests were repeated on 30th day if negative on day 10th. Results: In all groups, rapid improvement was seen at visit 2, which further continued at visit 3. No suppressive effect on hypothalamic–pituitary–adrenal (HPA) axis was seen. Conclusion: A short course of oral steroid of 25 mg of prednisolone equivalent for a period of 7 days was found to be effective and safe, and 7 days of oral steroids do not need tapering.