Corticosteroids: options in the era of steroid-sparing therapy

J Am Acad Dermatol. 2005 Jul;53(1 Suppl 1):S50-8. doi: 10.1016/j.jaad.2005.04.030.

Abstract

Topical corticosteroids remain the most commonly used topical treatments for inflammatory dermatoses, including psoriasis and atopic dermatitis. Topical corticosteroids are available in a variety of vehicles-creams, ointments, lotions, gels, and, more recently, foam. The vehicle used can substantially affect the individual agent's clinical action, potency, and acceptability to the patient. Moreover, some vehicles are better suited for specific body areas. Selection of the appropriate product should be determined by area of usage, physician experience, cost, and patient preference, particularly regarding vehicle. Although topical corticosteroids are associated with several side effects, including skin atrophy, telangiectases, purpura, and striae formation, appropriate usage can minimize these occurrences. Judicious use includes short-term, appropriate application as initial monotherapy or in combination strategies with other therapeutic agents that ideally possess complementing mechanisms of action. Examples include pulsing with high-potency topical corticosteroids and combination regimens with other topical agents such as topical calcineurin inhibitors, calcipotriene, or tazarotene. Appropriate education of patients and caregivers alike will facilitate the optimal use of these medications.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Topical
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Calcineurin Inhibitors
  • Calcitriol / analogs & derivatives
  • Calcitriol / therapeutic use
  • Child
  • Combined Modality Therapy
  • Dermatitis, Atopic / drug therapy*
  • Dosage Forms
  • Drug Therapy, Combination
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Nicotinic Acids / therapeutic use
  • Psoriasis / drug therapy*
  • Ultraviolet Therapy

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Calcineurin Inhibitors
  • Dosage Forms
  • Immunosuppressive Agents
  • Nicotinic Acids
  • calcipotriene
  • tazarotene
  • Calcitriol