SOME QUANTITATIVE FACTORS IN TOPICAL CORTICOSTEROID THERAPY.

Abstract

Corticosteroids are presently the most widely used and effective agents in topical therapy of cutaneous disease. The use of plastic film dressings increases the effectiveness of treatment, but also increases absorption and the possibility of systemic corticosteroid effects, and raises the question of possible adverse effects on pituitary‐adrenal function. A summary of previously published studies on this question is presented, and criteria for distinguishing transient adrenal suppression from true adrenal insufficiency are outlined. Proved cases of adrenal insuffiCiency caused by topical corticosteroids have not been reported, but the number of properly studied cases is too small for firm conclusions. The question of “dosage” of topically applied corticosteroids has heretofore received scant attention. A dosage schedule, which is effective treatment for many steroid responsive lesions and is below the range which produces significant systemic effects, is presented. The results of pituitary‐adrenal function tests in specific cases treated with known amounts of topical corticosteroids are presented. Because of the importance and widespread use of topical corticosteroids, it is urged that further study of these questions be pursued.